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Reflux laryngitis is the chronic irritation and swelling of the voice box or larynx caused by the backflow of stomach acids into the esophagus. This backflow is the result of gastroesophageal acid reflux, or GERD. There is a muscular valve located at the point where the esophagus and stomach meet that keeps stomach acid from flowing up into the esophagus and larynx. When this muscle sphincter is not functioning correctly, stomach acids can back up into the esophagus and irritate the vocal chords inside the voice box. Reflux laryngitis, a possible and common complication of GERD, is characterized by chronic hoarseness or voice loss, sore or dry throat, and dry cough.
The vocal cords are inside the larynx or voice box. They are two mucus membranes folded around muscle and cartilage. Sound is made when the vocal cords vibrate by opening and closing. When these cords become swollen and irritated, sound is distorted, and the voice can become so quiet that it is barely audible.
Stomach fluid includes acids used to digest food. These acids can irritate and even damage the esophagus and voice box if continually exposed over time. Increased abdominal pressure can push these stomach acids back up into the esophagus and cause heartburn, among other complications, such as reflux laryngitis.
Most cases of laryngitis are acute and caused by a temporary infection or from shouting or overusing the voice. In these instances, symptoms can be relieved by resting the voice and drinking a large amount of fluids such as water or juice. If voice loss and hoarseness persist for more than two weeks, reflux laryngitis becomes a possible diagnosis.
In addition to persistent voice loss and hoarseness, reflux laryngitis can cause other symptoms. Patients may clear their throats with increasing frequency or feel like there is a lump in their throats that cannot be resolved. A constant dry cough and raw, sore throat are also typical complaints.
The typical symptom pattern of chronic voice loss or hoarseness coupled with heartburn and GERD often make reflux laryngitis easy to diagnose. Patients who don’t respond to treatment may have to undergo further testing such as an esophagram, endoscopy, or laryngoscopy. Additional testing can help determine if the chronic laryngitis is really the result of GERD and not smoking, alcohol abuse, or sinusitis.
There are many treatment options for reflux laryngitis. Some treatments involve medications that prevent GERD. Other treatments involve lifestyle changes like losing weight, avoiding large dinners, and waiting several hours after eating to lie down. Alcohol, tobacco, and spicy and fried foods should also be avoided whenever possible.