Dear Dr. Jahn,
Has laryngeal acid reflux always been an issue for singers, or is it more prominent now because of changes in our foods and lifestyles?
– David K.
Dear David,
Your question is a good one and something that I have also been wondering about. Has the general incidence of reflux really increased over recent years? Or has reflux always been there, but not fully recognized in all of its different manifestations?
When I was in medical school, many years ago, the only symptoms of reflux that were recognized were a burning pain behind breastbone and a sour taste in the mouth. We now know that there are many versions of acid reflux, including LPR (laryngopharyngeal reflux ) which can manifest with symptoms as seemingly innocuous and nonspecific as a chronic cough, excessive mucus, sore throat, and even earache and sinusitis.
I think, however, that there actually is a greater incidence of reflux and this has a lot to do with our lifestyle. People tend to eat quickly, ingesting excessive amounts and often eating late at night with alcohol. The food that we eat travels over greater distances from farm to plate, and often arrived preserved, colored, and otherwise adulterated. We are also moving more quickly through our daily lives, not taking time to sit down for a meal and enjoying and digesting food properly.
Yet another consideration, however, is that the increased awareness of “reflux” has turned this diagnosis into a garbage can by which we try to explain variety of symptoms that we cannot find an obvious cause for. I see patients every day who are hoarse for a variety of reasons, but have been told they “must have reflux”. In such cases, we need to consider that if there is no improvement after a substantial change in diet and a good trial of anti-reflux medications, then reflux may not have been the issue.
