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Reflux! What Reflux?

By Daniel K. Robinson
(2007)

Do you regularly wake with a sore throat that is fine by mid-morning? Do you have a constant lump in your throat? Maybe youre suffering from reflux. Often associated with babies, reflux is also regularly observed in adults and even more so in singers. What is reflux? Reflux is the reverse flow of digestive acids and stomach contents up through the oesophagus. Symptoms might include a sensation of heart burn, irritable throat, gathering of thickened mucus causing a continual lump in the throat, and hoarse voice. In fact every human being has a normal reflux action as a part of their digestive process, but the normal can easily become the abnormal. Dr Sulica, a New York based ENT writes: Reflux is significant because the acid and enzymes that reach the larynx cause injury and irritation. The larynx is not as well protected as tissues closer to the stomach, and thus, it is damaged by contact with less stomach fluids than it takes to damage the oesophagus. This accounts for the phenomenon of silent reflux: reflux can cause irritation in the throat without creating more typical symptoms like heartburn or chest discomfort, which are caused by oesophageal irritation. (www.voicemedicine.com) Contributing factors which may heighten the effects of reflux include, spicy and acidic foods including curries and coffee; eating late and then going to sleep directly after eating. By raising the acid level in the stomach, any reflux of the digestive acids can heighten the severity of the injury and irritation. So what can be done to alleviate the effects of reflux? Discuss the symptoms with your doctor and if necessary ask for a referral to an ENT (Ears, Nose and Throat Specialist) to investigate any possible damage to the larynx. Reflux is the major contributor to the formation of granuloma. Adjust your diet to limit your intake of spicy foods and acidic beverages such as coffee and alcoholic drinks especially wine & spirits. Dont eat 3-4 hours before going to bed. This will allow your digestive system to process much of your meal and move it beyond the stomach into the intestines. Raise your bed head onto 2-3 house bricks. This lifts your head above your stomach and helps gravity feed your stomach contents back to where they should bein your stomach.

Daniel K. Robinson - 2010

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Medical treatment of reflux should be undertaken in conjunction with behavioural measures in order to be effective, and in consultation with a physician. The most powerful anti-reflux medications currently available are known as proton-pump inhibitors (e.g. Nexium, [Zoton], [Somac], and [Losec]). These are taken once or twice a day, 30-60 minutes before a protein-containing meal, which is needed to maximize the effects of the drug. Side-effects are usually absent or mild. Reflux may also be treated with an older, less-effective class of medications known as H2-blockers (Zantac, Tagamet, Axid) or common over the counter remedies such as [Mylanta]. Since reflux is a chronic problem, it may take several weeks to see a change in most laryngeal symptoms. The relative advantages and disadvantages of medications should be discussed in detail with your doctor. (www.voicemedicine.com) If you suspect that you might be suffering from the effects of reflux, then make sure you act promptly to avoid serious voice wear & tear. Implement any management options as discussed with your doctor and voice coach and you should be able to continue with healthy voice function.

Daniel K. Robinson - 2010

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