Are Heartburn and Hoarseness Related?

There are a number of different causes of hoarseness that must be considered when evaluating a patient with hoarseness issues. One of the more common factors, though, is inflammation of the voice box related to acid and other irritating fluids coming up from the stomach into the back of the throat.

Gastroesophageal reflux disease (GERD) is an extremely common medical disorder caused by fluid from our stomach coming back up into the lower esophagus and causing inflammation. The common name for this is “acid reflux,” although acid is really only one part of the problem. Heartburn is the most commonly associated symptom of GERD, but many, if not most, patients don’t ever report classic heartburn symptoms. When that fluid from the stomach comes higher up into the throat patients may experience a different range of symptoms and we refer to that process as laryngopharyngeal reflux (LPR). Reflux of both varieties has become more common in the United States due to poor diet, tobacco use, ulcers, and increased levels of obesity.

Not everyone that suffers from reflux symptoms fits this profile however. Pregnant women often suffer from reflux and some people have an anatomic predisposition to reflux called a hiatal hernia. This often explains why we can even see reflux in people who are very fit and have a very healthy diet. Stress also plays a large role in reflux. It's estimated that up to 10 percent of the population suffers heartburn on a daily basis, with up to 50 percent of people suffering intermittent heartburn.

Some symptoms of GERD include:

Heartburn after eating, which manifests as a burning sensation in the chest or throat
Sour or unpleasant taste due to acid coming up to the back of the throat
Bad breath
Belching and/or bloating
Painful swallowing and/or difficulty swallowing
Feeling nauseated
Hoarseness
Sensation of mucus or a “lump” in the throat

A number of airway problems are also very commonly linked to GERD, such as:

Laryngospasm
Chronic cough
Tracheobronchitis
Wheezing or Asthma

It is important to reiterate that the majority of patients with evidence of reflux related disease don’t ever report traditional “heartburn” symptoms. This is commonly referred to as “Silent Reflux,” though there are often other symptoms present. This is particularly important because chronic untreated reflux can be dangerous and even lead to cancer in the lower esophagus.

Some tips to reduce risks of heartburn and hoarseness and other symptoms of GERD include:

Increasing your level of exercise
Reducing your level of stress
Avoiding acidic foods (citrus, tomato, vinegar, etc.)
Avoiding caffeine, alcohol, and carbonated beverages
Avoiding eating meals two hours prior to bedtime and sitting upright during that time period
Wearing loose clothing
Raising the head of your bed

Anyone suffering continued heartburn and hoarseness or other symptoms of GERD/LPR is advised to consult a medical doctor, particularly if these problems are prolonged or severe.

Contact Silverstein Institute today to schedule an appointment with our specialists and get the help you need.