SWALLOWING AND VOICE
Advanced ENT specializes in treating all manner of swallowing and voice disorders.
Any interruption in the swallowing process can cause difficulties. Eating slowly and chewing thoroughly can help reduce problems with swallowing. However, difficulties may be due to a range of other causes, including something as simple as poor teeth, ill-fitting dentures, or a common cold. One of the most common causes of dysphagia is gastro esophageal reflux. This occurs when stomach acid moves up the esophagus to the pharynx, causing discomfort.
Symptoms of swallowing disorders may include:
- A feeling that food or liquid is sticking in the throat
- Discomfort in the throat or chest (when gastro esophageal reflux is present)
- A sensation of a foreign body or lump in the throat
- Weight loss and inadequate nutrition due to prolonged or more significant problems with swallowing
- Coughing or choking caused by bits of food, liquid, or saliva not passing easily during swallowing
- Voice change
Abnormal changes in the voice are called hoarseness. When hoarse, the voice may sound breathy, raspy, strained, or show changes in volume or pitch (depending on how high or low the voice is). Voice changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx).
Some causes of voice disorders may include:
- Acute Laryngitis. The most common cause is acute laryngitis swelling of the vocal folds that occurs during a common cold, upper respiratory tract viral infection, or from voice strain.
- Voice Misuse. Speaking in noisy situations, excessive use, using inappropriate pitch (too high or too low) when speaking and not using amplification when public speaking.
- Benign Vocal Cord Lesions. Prolonged hoarseness can occur when you use your voice too much, or too loudly for extended periods of time. These habits can lead to nodules, polyps, and cysts. Vocal nodules (singers nodes) are callus-like growths of the vocal folds.
- Vocal Hemorrhage. Vocal fold hemorrhage occurs when one of the blood vessels on the surface of the vocal folds ruptures and the soft tissues fill with blood. It is considered a vocal emergency.
- Gastroesophageal Reflux (GERD). A possible cause of hoarseness is gastro-esophageal reflux, when stomach acid comes up the swallowing tube (esophagus) and irritates the vocal folds.
- Smoking. Smoking is another cause of hoarseness. Because smoking is the major cause of throat cancer, if smokers become hoarse, they should see an otolaryngologist.
- Neurological Diseases or Disorders. Hoarseness can also appear in those who have neurological diseases such as Parkinsons or a stroke, or may be a symptom of spasmodic dysphonia, a rare neurological disorder that usually affects only the voice.
GASTROESPHAGEAL REFLUX (GERD) OR ACID REFLUX
Advanced ENT has been treating patients with Gastroesphageal Reflux (GERD) (more commonly know as acid reflux) for many years.
We manage laryngopharyngeal reflux as it often causes throat symptoms, however patients should seek evaluation by their primary care physician if they are experiencing other symptoms of GERD, such as chest pain. Chest pain may indicate acid reflux, but this kind of pain or discomfort demands urgent medical attention. Possible heart conditions must always be excluded first.
Acid reflux occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter, contracts to keep the acidic contents of the stomach from refluxing or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up the esophagus.
When stomach acid touches the sensitive tissue lining the esophagus, it causes a reaction similar to squirting lemon juice in your eye. This is why GERD is often characterized by the burning sensation known as heartburn. Occasional heartburn is normal. However, if heartburn becomes chronic, occurring more than twice a week, you may have GERD. Left untreated, GERD can lead to more serious health problems such as ulcers and strictures of the esophagus (esophagitis), cough, asthma, throat and laryngeal inflammation, inflammation and infection of the lungs, and collection of fluid in the sinuses and middle ear.
If you experience heartburn more than twice a week, frequent chest pains after eating, trouble swallowing, persistent nausea, and cough or sore throat unrelated to illness, you may have GERD. The physicians at Advanced ENT manage GERD symptoms related to the throat and swallowing, however, patients should seek evaluation by their primary care physician if they are experiencing chest pain, as this kind of pain or discomfort demands urgent medical attention. Possible heart conditions must always be excluded first.
THROAT AND VOICE CONDITIONS WE TREAT
Some of the more common throat and voice problems are listed below. Please click on the links below to learn more. For more information about any of these disorders and conditions or for questions about a condition not listed here, please contact us to schedule an appointment.
DAVID N SCHWARTZ, MD, FACS
Dr. David Schwartz graduated with a bachelor’s degree in biology from the College of William and Mary in Williamsburg, Virginia. He attended Boston University School of Dental Medicine earning a doctor of dental medicine degree followed by a medical degree from Boston University School of Medicine, Massachusetts.