Is your voice not working as it should? Are you having difficulty swallowing? You may require treatment for a voice or swallowing problem, which can be performed at Maryland ENT by one of our expert ENT specialists.

What is a Voice Problem? 

A voice problem, or dysphonia, is when a person’s vocal quality, loudness, or pitch does not meet their daily communication needs. Many patients seen at Maryland ENT are professional voice users, such as teachers, singers, actors, and others who rely on their voices to make a living.

Maryland ENT provides thorough evaluations and treatment to all people who are concerned about their vocal function.

Symptoms of a Voice Problem 

You may have a voice problem if you’re experiencing symptoms like:

  • Hoarseness, breathiness, or strain
  • Increased effort to use your voice
  • Pain when using your voice 
  • Vocal weakness
  • Vocal instability 
  • Difficulty being loud enough to be heard
  • Total loss of voice 
  • Frequent throat clearing or coughing
  • The feeling of a lump in your throat 
  • Any notable change in your voice that impacts your daily life

What is a Swallowing Problem? 

A swallowing problem, or dysphagia, is when moving food or liquid from the mouth, throat, or esophagus into the stomach is difficult or painful.

Symptoms of a Swallowing Problem 

You may have a swallowing problem if you’re experiencing symptoms like:

  • Coughing or choking with food or liquids
  • Wet or gurgly sounding voice or cough during or after eating and drinking
  • Food or liquid leaking out of the mouth 
  • Food or liquid getting stuck in your mouth or throat
  • Regurgitation of food after swallowing 
  • Pain with swallowing 
  • Needing extra time for meals 
  • Severe heartburn or tightness in the throat or chest
  • The feeling of a lump in your throat 
  • Recurrent pneumonia or chest congestion
  • Unintentional weight loss due to difficulty eating and drinking

Voice and swallowing problems can be caused and worsened by many factors, including reflux, allergies, underlying neurological disease, changes to head and neck anatomy, and injury to the voice box or nerves that control it. 

Maryland ENT specializes in diagnosing and treating voice and swallowing problems of any cause. Reflux disease is a widespread cause of these disorders. 

What is Gastro-Esophageal Reflux Disease (GERD)?

Gastro-esophageal reflux disease is a chronic condition in which stomach contents flow back into the esophagus. The esophagus is the tube that carries food and liquid from the throat to the stomach.

Once food or liquid enters the esophagus, it moves downwards towards the stomach. When it flows back up towards the mouth and throat, it is called “reflux.” 

What is Laryngopharyngeal Reflux Disease (LPR)?

Laryngopharyngeal reflux disease is a chronic condition in which stomach contents flow through the esophagus and reach the throat. Stomach acid irritates the delicate tissue in the voice box (larynx) and throat (pharynx).

Diagnosing GERD and LPR

An ENT specialist may evaluate you for reflux diseases like GERD and LPR by asking questions about your symptoms and medical history, completing a physical exam, and a laryngoscopy. A laryngoscopy is an awake, in-office procedure in which a thin tube with a light and camera is used to examine the voice box (also called “larynx”).

Your ENT specialist may recommend a few additional tests to confirm the diagnosis of GERD or LPR. These exams may include:

Modified Barium Swallow Study

A modified barium swallow study, also called a “video fluoroscopic swallow study,” is a video X-ray of the swallowing process. This test examines the swallow as the food or liquid enters the mouth, moves down the throat, and passes through the top of the esophagus. 

Esophagogram

An esophagogram is a video X-ray of the movement of food and liquid from the esophagus through the stomach and the first part of the small intestine. This test examines how food and liquid travel through the upper gastrointestinal tract. 

Esophagoscopy

An esophagoscopy is an examination that uses a thin tube, a light, and a camera to look directly at the esophagus. 

Esophageal Motility Exam

An esophageal motility exam, also called “esophageal manometry,” involves inserting a thin, flexible tube with pressure sensors into the esophagus to measure how the muscles contract. During this examination, patients may be asked to move, talk, swallow, or breathe to gather data about how the esophagus is working.

Esophageal Acid Probe Test

An esophageal acid probe test also called a “pH probe,” measures how often acid from the stomach is sent up through the esophagus. This wearable device measures the acid in your esophagus for at least 24 hours.  

Treating GERD and LPR 

If it is determined that you have reflux disease, your ENT specialist will likely recommend lifestyle changes to improve your symptoms. While lifestyle choices do not always directly cause GERD and LPR, they can contribute to the problem and exacerbate reflux symptoms. 

Your ENT specialist may prescribe a medication such as a proton pump inhibitor (PPI, also known as an “antacid”), histamine antagonists, pro-motility medications, and foam barrier medications. In some less common cases, surgical intervention may be recommended, especially when there is an anatomical cause. 

Lifestyle Changes to Prevent GERD and LPR

Lifestyle changes can help prevent GERD and LPR. These can include:

  • Remain upright for at least 30 minutes after eating and drinking
  • Avoid eating and drinking within two to three hours before bedtime
  • Eat smaller meals 
  • Manage weight if necessary
  • Decrease or eliminate alcohol consumption
  • Quit smoking
  • Wear loose-fitting clothing
  • Decrease foods that trigger reflux symptoms like caffeine, carbonated drinks, chocolate, peppermint, tomato, citrus fruits, fatty and fried foods, and alcohol

Are you suffering from voice and swallowing problems? Get relief by scheduling your appointment today at Maryland ENT in Lutherville and Baltimore, MD!