Laryngology 101 - Reflux Laryngitis

[mrcreyna13]

i have the red reflux

[madswody]

This looks like a damn talking vergina to me...

[2wheelsteve]

I have been a professional singer for all my adult life and four months ago I lost my ability to sing, I can talk fine but as soon as I try to sing I cannot reach even medium range, also no falsetto and no vibrato or very slow forced vibrato, I also have sinitus caused by reflux, I am not hoarse at all just no voice, also my epiglottis is sore??? will I recover?

[MrAUFANATIC]

Can anyone please tell me can tonsillitis cause laryngitis. I have tonsillitis, and i have been sleeping with the air conditioner on too. Can tonsillitis cause laryngitis. I would really appreciate the help thanks.

[docvox]

Respond to this video... 

[135970211]

@MrAUFANATIC It sometime can

[xsuexkilla]

I'm 20, just before May or April I was able to sing and had a really clear voice to even sing popera and extremely high notes. It was a really bad allergy season and my voice began going bad. It's as if my vocal chords feel dry. Then I got a really bad cold in May and my voice just disappeared for 2 weeks. It's June, my cold is gone but my voice is still not fully back. I can't hit high notes or anything higher than a F4-G4, I used to hit a D6. What is wrong with my voice? Help! I love singing.

[docvox]

@xsuexkilla someone would have to look at your vocal cords to give you an answer

[xsuexkilla]

@docvox I did the following month in July, and my ENT said I had voice nodules. I was told to rest my voice, but it was a hectic summer of traveling and church things that required singing and a lot of talking. This month in October, I decided to refrain from singing at all, which is really hard to do. But my voice seems to be doing fine, I'm just trying to avoid vocal chord surgery at all costs. My ENT said they'll just go away with voice rest and no singing.

[DeanoMcken]

how come i can sing, then next thing my throat hurts and i cant sing at all or hit the notes i could hit grr, it comes ever 3 months wtf???

[docvox]

@DeanoMcken A good question for a laryngologist who could look at your vocal cords and tell you the answer.

[ellianamuriel]

very informative!.i never thought hoarseness of voice is actually the of air leak...for many years i believe it was because of swelling or something of an inflammation.thanks for the info.God Bless.

[docvox]

@ellianamuriel Well, swelling of the vocal cords does mean that they no longer can come together and that they are stiff. Consequently air will leak around the swelling and it will require more air to push through the stiff cords.

[007ayala]

Thank you doctor, this time it was the worse

Than ever but thank God i am a lot better

But every time I drink ( beers) fells like I am

Lossing it again.

Next time I losse my voice I will do what

You told me to Do. Thanks again!!

[007ayala]

Very nice video.

I haven't be able to talk for a week

And fells like I am getting worse

I try so many things and everything is

Useless;(

Can someone HELP Me

[docvox]

@007ayala A good examination by a good laryngologist can be very helpful: voicedoctor.us/links/physician­s.

[buzzardkiller92]

@007ayala I'm having that same problem now.

[007ayala]

@buzzardkiller92 Oh man that is so horrible don't know how but is gone, I hope never come back. my brother never have this before and we rided together when we go work and some how he has now he can sleep at night he said is itchy. good luck with that remember drink a lot of tea, stay away from cold drinks and keep your voice low. Feliz navidad to you

[buzzardkiller92]

@007ayala I was severely coughing to the point of coughing up blood so I guess that's what caused it for me. I drink tea all the time and I hope it's clearing up. It's been 9 days since I was able to talk and now it's idled to where my voice will go in and out.

[breebreelala]

I have unbareable constant throat clearing, loss of voice and vocal range for about 6 months and i was told by an ENT doctor that it could be acid reflux but ive never had an acidic diet and ive even cut down my diet and it hasnt got any better. I'm having an endoscopy/laryngoscopy and I'm scared of them giving me an errored result, is there any way that you can suggest a clear endoscopy rather than a rigid one?

[sistagirl488deleted]

@breebreelala what did your endoscopy show?

[DapperDeb]

After a hysterectomy I woke up and it felt as though my throat had been torn up with a brillo pad. Threw up blood for two days! My voice deteriated from then on. Being a guitarist, pianist, singer, professional speaker, I was devastated! My OB/GYN kept telling me it would improve. Never did only worsened. Found out in transcripts of the surgery there was a problem with intubation causing slight bleeding. Yeah Right! The doctor wanted me to think I was crazy!! Have had surgery! Better than ever!

[ThePollytheparrot]

are you supposed to get surgery for that i just recovered i have a bad cough i skipped 2 presentations at school :D and i had fever NO voice etc.

[enchanteDREAMer01]

I sorta want to get my vocal cords checked cuz my throat seems to be feeling tired for a very long time now. I'm worried that something's wrong...

do u have to pay for a check-up?

[TheFasteddie16]

i wish he was my doctor ..i took this test... and the dr did nothing i sounded awfull

[sistagirl488deleted]

@TheFasteddie16 do you have chronic hoarseness? what did your laryngoscopy show?

[sistagirl488deleted]

i've been on Omeprazole (Prilosec) for a month since a dr. diagnosed me with LPR (reflux laryngitis) by just looking at my larynx, i had another laryngoscopy a month later 4 days ago and my larynx doesn't look the same it looks worse now my right laryngeal ventricle looks wide open according to my new ENT that's due to abuse he sent me to speech therapy and said i should continue with omeprazole...

[awfulguitarplucker]

now.speaking of "speak" .somebody shall explain me why,in teh Friggin english the "H" letter in the middle of the word "Chord" is not pronounciated resulting in makein sound the word Chord" exactly like "Cord"

[dno2fly]

hi .. would you be able to do a check up on me.. i have run into lots of dead ends with my doctors here for my throat.. please let me know

[voiceproblemsupport]

Excellent video. I have had a diagnosis of LPR for many years. My voice problems started after being intubated and a stenosis developing. When the stenosis was removed but I continued to experience problems such as pain and discomfort on speaking. LPR was diagnosed. As Dr Thomas indicates, I have not responded much to reflux treatment despite the diagnosis. I have been treated for laryngeal fungus infection on a speculative basis once and wonder if one could have such an infection for yrs?

[turadd]

Good job, Dr. Thomas!

[sxb21715]

Thanks for the video. I was wondering if you have any insights into a problem i have had for about 5 years. I have a constant tension and feeling of 'something in my throat' that can range from uncomfortable to sore. The tension and soreness is just above the adams apple and located at what i believe to be the larynx area. My voice is horse and most of the time I struggle to enunciate words properly. It also greatly affects the clarity of my voice and is sore when i speak. Thanx for any help

S

[msborn2sing]

this is creepy.. :0

[ChazzanBabinet]

This is a very controversial perspective with which I strongly take issue. Acid reflux, besides causing pacadermia and the other problems you mentioned, are known to cause sinusitis, post nasal drip and other nasal problems. These issues are indeed known to directly cause laryngitis. Therefore we must conclude that there is a very close relationship between reflux and laryngitis. I understand that in some cases you found a mechanical issue to be the culprit but that is not the norm.

[liaxi65]

I suddenly developed a very hoarse voice about 12 years ago. The only time I seem to be able to talk is about a day or two after the onset of a cold. It seems that the swelling of the mucus membranes allows the folds to come together. About 4 years ago I saw an ENT who did a laryngoscopy. One of the sides was not moving at all. It was like it was paralysed open. He diagnosed me with GERD and prescribed a reflux controlling drug. No effect. I gave up and continue to live without a voice.

[docvox]

Certainly a paralyzed vocal cord is not due to reflux, so getting no response to treating a paralysis with a reflux controlling drug is not surprising. I do have some videos posted about vocal cord paralysis. However, if a doctor is diagnosing paralysis and then treating GERD, one would even question the diagnosis. Perhaps a second opinion might be useful.

[ShirakOmegaX]

@liaxi65 Hey I had similar I gave up yeast based food and cheese and it went away after several days after 2 years of suffering I hope this helps

[ledhead923]

For me personally, I am not hoarse in a way like a person who has laryngitis. My voice goes kaput and my throat becomes swollen after 5 minutes of singing. I think Reflux irritates the area, and then singing irritates the already swollen area.

[violetrav1]

I also believe the interarytenoids DO play a role in "vibration" of vocal folds, as they are what bring the folds together to vibrate ... I believe that reflux causes these arytenoids to WEAKEN as well as the laryngeal nerve (in severe cases of acid reflux) and thus becomes the basis for other vocal cord dysfunction (i.e., nodules, muscle tension dysphonia and even paresis)

[docvox]

Of course, everyone is entitled to their beliefs. However, for all the professional meetings I attend, no one has ever shown a before and after video (where the only intervention was "reflux treatment") and demonstrated any physical alteration in vibrations. There is a substantial difference between cause/effect and simultaneous events.

Sorry, unless you are Tuvan throat singing, your arytenoids are not producing sound.

[violetrav1]

Thank you for taking the time to reply to my post ... I mean no disrespect, but your video and claims that acid reflux does not participate in vocal cord/phonation dysfunction made my blood boil a bit ... like I said, I have had vocal phonation problems for the past several months and now coming onto week three of 40mgs a day of omeprazole (and some dietary changes, i.e., no coffee), I have noticed a DRAMATIC change in my phonation, ease of cord fuction.

[violetrav1]

I am also aware that the arytenoids do not "produce" the actual sound and vibration, BUT they do allow the vocal folds to be tensed, relaxed, or approximated. I believe reflux has also somehow affected this area and since taking the meds, I have found that the onset of producing tone has also been dramatically improved...

[violetrav1]

Fascinating topic because I have a direct experience with this physically and I just want other singers that may read this post to hear of my experience as well ... best to you and many thanks for listening.

[gwrapoza]

violetrav1, I just want to point out that it may be possible that an overcompensation for the vocal discomfort caused by the refulx could be the reason for the vocal issues. Docvox is not wrong at all in what he says, but I do see your point too, as I, too, am a reflux sufferer with a singing career. From my experience, anytime I have trouble singing while having reflux problems, it is due to a tendency to sing in an unhealthy manner without realizing it. It might be that way for you too.

[violetrav1]

I am in agreement with what you say, gwrapoza. I believe reflux causes a singer to find "other" ways to produce a clear sound ... thus, the vocal dysfunction ... I continue to take omeprazole to neutralize the acid production, but in the long term, I do not feel very comfortable with this solution either due to any gastrointestinal issues that may arise over long-term use. My voice continues to improve and heal while taking the omeprazole. Thanks for your input.

[docvox]

To all, just remember co-incidence is not causation. One of the great problems in medicine is confusing co-incidence with causation. Take for example vocal paralysis, where after an injury the nerve spontaneously recovers up to 90% of the time over a year. Many people (patients and health care workers) will often attribute healing to whatever intervention they were applying at that time. If they had done nothing the same improvement would have been noted during the same time period.

[violetrav1]

I understand your post, Doctor, however, in my case, I do not believe that it is "co-incidence" that my voice began properly phonating and my range (both upper and lower) has returned since starting the treatment of Omeprazole. I must tell you, the difference in my voice since beginning this course of therpay a month ago has been rather dramatic.

[violetrav1]

It is noiw MUCH easier to resonante and achieve a resonant "placement" of the voice (opera) and with much less effort. I am truly convinced reflux takes some large part in the cause of my vocal dysfunction; I truly hope more studies are conducted with regards to LPR and the singing voice. Best regards.

[landwherethenutsgrow]

Thank you for that. I was just scoped today and told that there was some severe inflamation due to acid reflux. I can tell when I have had an attack--not because of hoarseness, but because of extreme fatigue and the sensation that I cannot get on top of my voice...it's just too weakened. In any case, I begin treatment now, and I hope that this will prevent overcompensation patterns that strain my voice further...Wish me luck.

[violetrav1]

@landwherethenutsgrow Hi ... just wondering how you are doing with your reflux issues ... I also experienced extreme fatigue and just proper phonation in general before taking omeprazole ... I have been taking the drug now for about 2 months and notice steady improvement, with range and resonance returning ... MUCH easier to sing again! Hope all is well with you ...

[violetrav1]

I would actually suggest that many vocal disfunction is DUE to LPR!!!

[violetrav1]

DRASTIC improvement ... it DEFINITELY was responsible for my reflux laryngitis! My vocal technique is SOLID and the ONLY explanation for my vocal hoarseness/dysphonia was due to acid reflux (LPR) ... NO QUESTION

[violetrav1]

HE IS WRONG!!! I am an opera singer and have had much trouble with my voice production due to reflux ... I have been taking 40 mgs of Omeprazole for three weeks and notice a DRASTIC

[cooldude22032]

i have laryngitis:(

[WhateverNevemind]

He rocks!

[Denuhm]

Oh GOD those polyps have made me want to die *cries*

[bar77FUL]

Brilliant video thanks for putting this together and sharing it

[Goanna1234]

i think i hav that i can barley talk and i cant stop coughing

[xskullfirex4]

awsome

[494c6f7665416c6578]

He has a very colourful keyboard.

[northwestmike]

He probably drives a rainbow-colored car, has a rainbow umbrella, and lives in "colorful" San Francisco.

[reverseheavendotcom]

they are color coded shortcuts for various programs.

[Goanna1234]

lol

[paperandtea]

has anyone got any advice to get my doctor to take me srious cos he does that put his finger on my throat thing and say evrythings ok

[JamesCecilia]

you're an amazing ENT I wish you lived in my area. I can't figure out for the life of me what causing my vocal problems. I thought it might have been reflux up until now...

[paperandtea]

yea he is amazing and this is to..i woke up one morningand my vpoice was fucked...and 3 months on it still is my doctors aint helping me one bit so im going 4 another appoinytemnt its depressing me cos im a comedian and impressionist so i need my voive it hurts somtimes whats wrong with urs

[RefluxRepresentative]

gross

[Firebutton]

I went to see an ENT because I had consistent hoarseness in my voice lessons and at the end of voice lessons my voice would feel quite raw. What I learned was that I had mild reinke edema, so he suggested voice therapy. I feel I have improved in terms of vocal onset with vowels, but I'm still dealing with discomfort from a lack of focus in the voice as well as fatigue from hyperfunction. I'm still in voice therapy, but in many ways I feel I've taken a step backwards. Any suggestions? Thank you!

[docvox]

Technically, I have only encountered Reinke's edema in smokers who are extremely talkative; so do you have it or not? A correct diagnosis is essential to deciding what treatment is appropriate. As for hyperfunction, that is a term that is used in several different ways, so it is difficult to know what is your particular issue. If you don't improve, then consider a second opinion.

[restate123]

I think I may be suffering from Reinke's edema. I WAS a smoker untill december of 08. I am really talkative. I think with the holiday season, smoking, and talking a lot messed up my voice. actually I'm positive thats what messed it up. Its been almost 6 months now and My voice hasnt returned to normal. Hoarsness comes more frequently on high pitch and lowers pitch. My voice also feels weak on higher pitches. what is the treatment if reinke's is the cause?

[slamedclon18z]

thank you

[slamedclon18z]

as of right now I have a tracheostemy and my ent doctor will perfrom surgery on may 11. He explained that one of the functions of the vocal chord may be comprimised either swallowing,breathing or voice. With these expectations what would be your advice if one would had to pick between one of the functions?

[slamedclon18z]

I was in a severe car accident with a skull base fracture and multiple other traumatic lesions, aswell it seems like a had a fracture to the cricoid cartilage and now with cricoidtracheal stenosis (which is just right above of the vocalchoards) and bilateral vocalchord paralysis in lateral position. I went around two weeks ago to get an electromyogram of the larynx and results where that no electrical frequency found on left chord and a little on right chord but when not phonating.

[katemccrew]

can cayenne pepper and apple cider vinegar help?

[omidr]

how do u apply antifungal agents to the chords?

[docvox]

You don't to my knowledge. It is possible to take a pill to treat fungal overgrowth or it is possible to stop a medication that might be predisposing a person to fungal overgrowth.

[Schistosum]

i have a question. I can produce my talking voice but i cant sing the high head voice that i used to hit. Tell me, what could be the problem? and how can i treat it.

[docvox]

That would require a good laryngeal exam - a laryngoscopy and likely a stroboscopy.

[acerocks34]

Are you supposed to drink water?

[PeterCarville]

I Have Laryngitis Now I cannot Talk at all i sound like a frog waaaaaaa

[mermaidamp]

You do? Please rest your voice.

[ivetaLOVESlime]

im in a choir so i sing almost every day. but sometimes when i sing regular notes, i find my voice cracking randomly. but i can reach extremely high notes so its not because i went out of my range. is this bad?...

[docvox]

There is more than one reason that you may have cracking in your mid or upper range, yet have clearer notes beyond that. Really, only a detailed exam could confirm the source of the breaking.

[lazkren]

Really fascinating video; it was very educating to find out more about how vocal cords work.

[docvox]

Good Question. I have not heard from my colleagues who believe that LPR causes hoarseness any reasonable physical explanation about how acid presumably touching the larynx impairs vocal vibration or allows air escape. About the closest reasonable explanation is that it would cause swelling of the vocal cords. That should deepen the pitch & seldom is that a persons complaint. I'll keep an open mind for any good explanation. Who has one? JPT

[typicalfatsoprano]

My husband, an opera singer, has a hiatal hernia. Two months ago he got a severe cold, and the doctor put him on prednisone. He just started rehearsals for an opera which requires much of his higher range. He was having a lot of vocal fatigue and also pain from singing. The doctor scoped him and said that his folds were burnt from the acid from his reflux, which the medication caused. Can acid burn your folds that much? He didn't have hoarsness, just pain and fatigue.

[docvox]

If water touches your vocal folds, they go into a rather intense spasm. It is very difficult for me to believe acid can touch them with no knowledge of the event.

I have always found other reasons for pain and fatigue, but you will have to judge the specific opinion of your doctor. If in doubt, then consider a second opinion.

[ryandsucks]

So do you dispute the existence of LPR, or are you just saying that it is not the most common cause of horseness? I have not found any other diagnosis that explains all of my symptoms (hoarseness, excess phlegm, globus, and severe pain). It's been over a year now with no relief. Should I be seeing an ENT, rather than a gastroenterologist?

[docvox]

Several possibilities. There is always a muscular limit to the tension of the vocal cord beyond which you cannot go. If you can hit a higher note though, but not one below it, then there may be a physical obstruction, such as a swelling, or a gap from neurologic cause, muscle weakness, closure technique, nodule/polyp etc

[SomethingWicked98]

watsup doc how fast can a vocal nodule or polyp develop on the vocal chords? And do u nedd to have had many vocal strains to develop them? Also what is considered vocal strain? a loss of voice or just hoarseness?

[oohmissk]

Hello Dr Thomas. What is the difference between not being able to sing a note due to unwanted air escape (whatever the cause), versus that note just not being in your range?