Voice Hygiene
Your problem has been identified as a combination of habitual behavior and unconscious reflux of stomach acid or GERD and LPR.
GERD is what is also known as ‘heartburn.’ Acid reflux into the esophagus is GERD. When the acid gets to the throat it is called extra-esophageal or Laryngo-pharyngeal reflux (LPR). The pharynx, larynx and posterior nose cannot tolerate ANY acid. Even a single episode of reflux is bad. Thus LPR needs to be treated aggressively, OFTEN FOR 3 MONTHS.
In order to gain control of this malady, you will need to understand the physiology of swallowing and regurgitation of stomach contents and acid.
Most regurgitation probably occurs at night, when we are supine. Especially after a large meal, this can be a problem. In addition, allowing 3-4 hours for the PM meal to digest before bed is even more important as we age.
Use of antacids (TUMS), H2 blockers (Zantac, Pepcid) and PPI’s have all helped the neutralization of the acidic refluxate, but the upright posture, digestive process and time of retiring are also very important.
We believe that twice daily PPI’s such as Nexium, Prevacid, Aciphex, Protonix or Prilosec-OTC are necessary in the beginning. Perhaps you can transition to once daily after 2-3 months. These PPI’s need to be taken ½ hour prior to the AM and PM meals to be effective.
eech/swallow therapy to reduce and control the habitual voice/swallowing problems is also necessary. Daytime throat clearing and frequent swallowing of air, as in a “dry” swallow, is NOT helpful. Swallowing air or aerophagia can lead to ‘burping’ and thus further acid reflux. These habits cause further swelling of the larynx and ADD to the problem.
Thus, carry water (H2O) and drink it often, spray your nose with Ocean Saline Spray, chew BICARB gum (Arm and Hammer) and use citrus lozenges in order to keep moist and avoid the “dry” swallow. Avoid anti-histamines and other drying agents as much as possible, yet keep taking your present medication.
Do NOT clear your throat. Instead, swallow fluids.
With medication, control of habits and some speech therapy, your problems should be improved.
Thus:
H2O and other fluids
PPI’s
Ocean Spray
Bicarbonate gum
Citrus Lozenges