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Can Silent Reflux Affect Your Voice? Understanding the Connection

woman coughing

Laryngopharyngoreflux (LPR), also known as silent reflux, respiratory reflux or extraesophageal reflux, occurs when stomach acid and digestive enzymes flow back into the larynx (voice box) and pharynx (throat), causing irritation and inflammation primarily in the upper respiratory tract. Unlike gastroesophageal reflux disease or GERD, where heartburn is a hallmark symptom, LPR often manifests with "silent" symptoms such as:


  1. Hoarseness: Persistent hoarseness or voice changes are common in LPR due to acid irritation of the vocal cords.

  2. Chronic Cough: Individuals with LPR may experience a nagging cough that persists despite treatment for common respiratory conditions.

  3. Throat Clearing: Frequent throat clearing or a sensation of a lump in the throat (globus sensation) can be indicative of LPR-induced irritation.

  4. Sore Throat: Patients may complain of a chronic sore throat, often mistaken for recurrent viral infections.

  5. Difficulty Swallowing: Known as dysphagia, difficulty swallowing may occur due to inflammation and narrowing of the throat caused by LPR. Foods or liquids may feel slow to travel through the throat or feel stuck and won't go down.


How does a speech-language pathologist help with silent reflux (LPR) and your voice.


  1. Voice Therapy: LPR can cause inflammation and irritation of the vocal cords, leading to voice changes such as hoarseness or loss of voice. Speech pathologists can provide voice therapy techniques to reduce strain on the vocal cords, improve vocal quality, and promote healthy vocal habits.

  2. Vocal Hygiene Education: Speech pathologists can educate individuals with LPR on proper vocal hygiene practices to minimize further irritation to the vocal cords. This includes techniques such as staying hydrated, avoiding vocal abuse (such as excessive throat clearing), and maintaining good vocal habits.

  3. Swallowing Assessment and Therapy: LPR can also affect swallowing function, causing discomfort or difficulty swallowing. Speech pathologists can conduct swallowing evaluations to assess any swallowing difficulties and provide therapy techniques to improve swallowing function and reduce discomfort.

  4. Reflux Management: While speech pathologists don't directly treat reflux itself, they can collaborate with other healthcare professionals, such as gastroenterologists, otolaryngologist/ENT's, and dieticians to manage reflux symptoms. They may recommend lifestyle modifications, dietary changes, or positioning techniques to help reduce reflux episodes, which in turn can alleviate symptoms affecting voice and swallowing.

  5. Breathing and Relaxation Techniques: Chronic coughing and throat clearing associated with LPR can strain the vocal cords and exacerbate symptoms. Speech pathologists can teach breathing and relaxation techniques to minimize these behaviors and promote a healthier vocal environment.

  6. Communication Strategies: LPR symptoms like hoarseness or throat discomfort can impact communication. Speech pathologists can work with individuals to develop strategies to optimize communication effectiveness, such as adjusting vocal intensity or utilizing alternative communication methods when necessary.

A speech-language pathologist (also called speech therapist) can play a crucial role in the comprehensive management of LPR by addressing its impact on voice, swallowing, and communication, and by providing strategies to alleviate symptoms and promoting vocal and swallowing health.


Lake City Speech & Voice Therapy, PLLC can help you manage your silent reflux symptoms and get you back on track to a clearer voice with less throat irritation. Reach out to discuss how we can help!





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