Reflux and Speech Pathology – What You Need to Know

Did you know that reflux may be one of the reasons you or someone you love may need to see a Speech Pathologist? While it might sound surprising at first, there are significant impacts that long-term acid reflux can have on a person’s voice and swallowing.  

Usually, reflux isn’t identified as a contributor to voice and swallowing difficulties until an assessment is completed by a Speech Pathologist and/or Ear Nose and Throat Specialist.

Keep on reading to find out more about what reflux is, the different types, and how reflux can impact your voice and swallowing.  

What is Reflux 

Reflux is a general term used to describe when stomach acid is not contained within the stomach and instead, makes its way “back up” into your oesophagus (food tube) and pharynx. Sometimes reflux can even get as far as the nose or even your mouth – over time, wearing away the protective covering on your teeth! 

There are three main types of Acid Reflux: 

  • Gastroesophageal Reflux Disease (GERD/GORD) 
  • Non-Erosive Reflux Disease (NERD) 
  • Laryngopharyngeal Reflux (LPR/Silent Reflux) 

While these three types are all considered reflux, they can differ in the types of symptoms you’ll experience, how you can get diagnosed, and which treatment approach works best. 

Let’s explore these three types of reflux and the symptoms you’ll experience in more depth. 

Gastroesophageal Reflux Disease (GERD/GORD) 

GERD is the most common type of reflux, where stomach acid frequently flows back into the oesophagus, often causing pain, known as heartburn. This occurs because the lower oesophageal sphincter (LES), that usually keeps foods and drinks in your stomach, weakens or relaxes abnormally.  

GERD symptoms include: 

  • Heartburn 
  • Regurgitation 
  • Difficulty swallowing (dysphagia) 
  • Chest pain (because it is in similar area, not actually due to heart!) 
  • Chronic cough 
  • Frequent laryngitis 
  • Sensation of a lump in the throat 
  • Increased salivation  

Long-Term Impact of GERD 

GERD can have serious long-term impacts if not managed appropriately with the support of healthcare professionals. The oesophagus is not designed to withstand stomach acid long-term. 

Long-term GERD can lead to:  

  • Irritation  
  • Inflammation 
  • Esophagitis (inflammation of oesophagus) 
  • Oesophageal stricture (narrowing of the oesophagus due to scar tissue) 
  • Barrett’s oesophagus (a precancerous condition) 
  • Increased risk of oesophageal cancer.  

Non-Erosive Reflux Disease (NERD) 

Non-Erosive Reflux Disease is a form of GERD characterised by presence of reflux symptoms without the visible oesophageal muscle injury typically seen in people with GERD. These individuals may have higher tolerance to acid in the throat, however, tend to experience similar symptoms and consequences of long-term exposure.  

NERD Symptoms include: 

  • Heartburn 
  • Acid regurgitation 
  • Dyspepsia: general stomach discomfort  
  • Chest pain: non-cardiac chest pain 
  • Chronic cough  
  • Hoarseness/voice changes  
  • Sore throat/throat clearing  
  • Difficulty swallowing (dysphagia) 
  • Asthma symptoms  
  • Dental erosion 

Laryngopharyngeal Reflux (LPR) 

The third type of reflux we’ll cover is Laryngopharyngeal Reflux. This is most commonly seen in singers, performers, and people with highly stressful jobs. Environmental changes are known to influence reflux symptoms in professional performers for example: performing late at night, eating food late, being in a new city with new foods. 

Laryngopharyngeal Reflux Symptoms include: 

  • A sore throat  
  • A sensation of a lump (globus)  
  • Voice changes  
  • Excessive mucous  
  • Need to clear the throat  

This type of reflux is often referred to as “silent reflux” because the more obvious symptoms of reflux, like heartburn, may not be present. Instead, you are more likely to notice symptoms like frequent coughing and throat clearing, which over time may lead to other unwanted symptoms like your voice getting rougher or breathier, or finding your voice tiring easily throughout the day. 

What You Should Do If You Have Reflux

If you have been experiencing reflux-like symptoms for a prolonged period of time, it is important to see your GP for support in addressing this symptom. If left untreated, you may experience changes in your voice and swallowing, or an increase in other symptoms like frequent coughing and throat clearing that can be uncomfortable and frustrating. 

If your voice and swallowing have been disrupted due to reflux, it is worth seeking out an instrumental assessment. This can be conducted by an ENT, or a Speech Pathologist with advanced training. Speak and Swallow Speech Therapy provide instrumental assessment from the comfort of a private Speech Pathology clinic in Burpengary East.  

Get in touch with our friendly team to find out more about our instrumental assessment services.