If you’re experiencing reflux, your digestion system needs your help to get healthy!
Often you won’t feel reflux, also known as heartburn or GERD, until the acid has traveled pretty far up your esophagus. Once it gets on your vocal folds it can be quite irritating, and can cause your voice to be scratchy, darken, or break when you talk.
Let’s talk about what to do to help your body and voice be at their best!
MEDICINE
Your doctor may prescribe medicine that decreases the amount of acid your stomach produces, such as Omeprazole. Reflux medicines don't prevent reflux, so it is important to also manage your reflux. How you sit when you eat, what you eat, and even how you sleep can make a big difference in how much your reflux affects you.
DIET
What foods exacerbate reflux varies. For some, bread or acidic foods such as lemon or tomatoes cause burning. In others, dairy or high fat foods are the irritant. Overeating is a common trigger, and some people find they experience reflux less when they eat smaller meals.
PILLS
If your body isn’t carrying pills you swallow all the way to your stomach, they can irritate the lining of your esophagus. Crushing pills and mixing them with pudding, apple sauce, or yogurt, can help ensure pills get absorbed in your stomach. If you don't like the bitter taste of crushed pills, try using one of the purees above with whole pills to help them go down more smoothly.
Pharmacies sell pill crushers, and can advise which pills can safely be crushed.
SIT UP
Gravity is your friend at meals! Aim to eat fully upright, ideally 90 degrees. Try to stay sitting up for at least half an hour after you eat, until your body finishes digesting the food in your stomach.
SLEEP CARE
When it comes to sleep, gravity is again your friend. Putting a brick under each of the bed posts by your head can give you a little elevation, which helps keep the acid down at night. If you have a hospital bed, you can raise the head of your bed to 45 degrees.
Timing is also important- try not to eat close to bedtime. How close to bed you can eat varies, but generally aim for at least 30 minutes.
Wondering how to know if you're having reflux?
With the right tools, we can see reflux, whether or not you're having symptoms.
IMAGING
There are several tests that look at the inside of your body that might find reflux.
Speech-language pathologists use MBSS, modified barium swallow studies, also called swallow studies, to see what is happening to food or drink when you swallow. During this test, we scan all the way down the esophagus. We’ll see what you ate sitting in your esophagus if your food or pills aren't emptying into your stomach timely. If your food isn’t getting into your stomach timely, you may feel full after eating only a small amount of food, and if you keep eating it may come back up.
During an upper endoscopy, GIs insert a camera on a thin, flexible tube down your esophagus all the way into your stomach while you sleep. Sometimes, over time reflux causes the esophagus to narrow. If they have trouble passing the scope into your stomach, they can use an air balloon to widen your esophagus. It will stay widened for some time after the test, making it easier to move food into your stomach.
These are standard reflux precautions. Please ask your doctor what is best for your health.
Managing reflux is just one part of a comprehensive vocal hygiene plan. Ready to work on your voice? Set up an appointment with Harmonic Speech Therapy to learn more!
-Tallulah Breslin, MS, CCC/SLP (she/they)
Gender & Identity Affirming Voice Training @Harmonic Speech Therapy
