Laryngitis

Laryngitis, which causes hoarseness and possibly a temporary loss of voice, is caused by an inflammation of the larynx that occurs in two forms:

• Acute - lasting only a few days
• Chronic - persisting over a period of weeks, months or even years

Laryngitis is usually caused by a virus, and may result from excessive strain on the vocal cords, as occurs with activities such as yelling, cheering, singing, or public speaking. Chronic laryngitis may be caused by excessive alcohol, smoking, or constant exposure to dust or chemical irritants like paint remover.

Postnasal drip, allergies, or inhalation of smoke fumes, or caustic chemicals can irritate the larynx and cause inflammation. Chronic upper respiratory tract disorders such as sinusitis, bronchitis, and allergies can also cause chronic laryngitis. Gastroesophageal reflux is also a common cause of laryngitis. Slightly swollen, red, inflamed vocal folds with sticky, white, mucous is an indication of acute viral laryngitis.

In most cases, laryngitis is a minor ailment and clears up on its own within a few days or weeks. Some measures a patient can take on their own include:

• Avoid public speaking during recovery
• Be aware that whispering puts greater strain on the vocal cords than normal speaking
• Inhale steam from a bowl of hot water or from a warm shower
• Drink warm, soothing liquids (but do not drink alcoholic or caffeinated beverages)
• Try a cool-mist humidifier; avoid air conditioning
• Use nonprescription pain relievers and throat lozenges to ease the discomfort
• Smoking cessation can not be emphasized more strongly

Reflux laryngitis

Changes in voice and hoarseness can be the result of a number of different causes. One of the more common causes is gastroesophageal reflux. Gastroesophageal reflux occurs when stomach acid regurgitates back up the esophagus (swallowing tube) into the back of the throat.

This reflux can result in irritation to the back of the throat with some swelling in the throat or in the larynx (voice box) and can result in a number of different symptoms:

• Mild hoarseness, which is typically worse in the morning
• A sense of a foreign body or lump in the throat
• A sense of mucous sticking
• A need to frequently clear the throat
• A chronic cough, particularly a cough that wakes people up in the middle of the night.

Gastroesophageal reflux

Gastroesophageal reflux, which tends to become more prominent as people age, is often related to the timing and type of diet and may be the source of chronic or irritating symptoms.

The diagnosis of gastroesophageal reflux as a cause of laryngitis or hoarseness is usually based on symptoms and appearance of the larynx and more significant testing is often not needed.

However, on some occasions, additional tests may be required such as a swallowing study with barium, an evaluation of acid in the esophagus (using a pH probe) or endoscopy of the esophagus and stomach. It’s important to realize that approximately 50 percent of patients do NOT get classic symptoms (heartburn, acid indigestion), and only get reflux laryngitis, so they don’t suspect they have reflux.

The most important treatment of gastroesophageal reflux is dietary control. A somewhat blander diet, smaller but more frequent meals, avoidance of alcohol, tobacco, and caffeine, not eating within 3-4 hours of bedtime, and elevation of the head of the bed may be helpful. The avoidance of tight, binding clothing may be of some value. A person with reflux who is overweight should reduce weight, and reducing stress also frequently improves the symptoms.

A number of medications can be used to decrease gastroesophageal reflux related throat symptoms, including antacids, stomach acid blockers and proton pump inhibitors.