Dear Weijie,
I am not a "voice doctor". However, I am an MD [cardiology] and do
see a lot of patients with "heart burn", the usual symptom of "acid reflux",
or more properly, gastroesophageal reflux disease [GERD]. It is caused by
splashing [reflux] of the acidic contents of the stomach upwards back into
the esophagus. If the reflux is severe enough, the contents can pass all
the way back up into the posterior pharynx and back down into the larynx
[particularly while the patient is asleep] to cause "reflux laryngitis"
during which the vocal folds may be severely irritated, and inflamed. With
continue irritation, ulcers may form on the vocal folds, and later, if left
untreated, scarring and nodes with permanent damage.
Treatment is directed towards prevention of reflux and
neutralization of the acidic contents of the stomach. Reflux prevention
includes conservative measures such as "grazing" type eating habits, meaning
frequent small meals rather than large meals, weight loss, placing blocks
under the legs at the head of the bed, avoidance of foods/drugs (caffeine,
alcohol, chocolate) that can decrease the tone of the lower esophageal
sphincter ("LES", a kind of valve at the gastroesophageal junction), and
medications such as metoclopramide to increase the tone of the LES, and
finally surgery to support the LES by wrapping the upper part of the stomach
around it (fundo-plication). Acid neutralization (an adjunctive measure
really, because the non-acidic contents of the stomach can still damage the
delicate vocal folds) usually consists of medications like H2 antagonists
(Zantac, Pepcid, Axid, Tagamet, et al) or Proton pump inhibitors (Prilosec,
Prevacid, Nexium).
If you think you may have reflux laryngitis, you must see an
otorhinlaryngologist for further evaluation and testing. If you think it's
just "heartburn", please start with your family physician or internist; but
don't be satisfied with just a prescription for an acid neutralizer
medication. Reflux prevention is paramount, especially for singers.
GWendel (tenor who's enjoying learning Grimoaldo in Handel's _Rodelinda_).
Fondest regards to all!
At 05:08 AM 4/9/01 -0000, chenweijie81@y... wrote:
>Dear teachers and friends out there,
> well I am a guy who have just joined vocalist-temporary.It's
>been really interesting reading all those messages out there.Indeed
>my knowledge of singing have increased a lot just by reading these
>messages here.Just a intro about myself:I am currently joining a
>choir in Singapore and my voice still remains as a 19 year old
>baritone.Just a question to ask: What exactly is acid reflux???I know
>I have been hearing a lot about it but still have no idea about
>it.How does it occur and are there any methods to prevent or reduce
>acid reflux???Thanks a lot.It would be helpful if voice doctors could
>explain over here.
>
>FROM NATURAL BARITONE
>WEIJIE
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