Handling Hoarseness With Heartburn Medication
May 24, 2001 -- For most people, laryngitis is an occasional annoyance that happens when you have a cold or your allergies act up, but for some people it can last for weeks or months and nothing they try -- from resting their voice to downing as much honey and lemon as they can stand -- seems to make it any better.
Now new research suggests the same medicine used to treat chronic heartburn can help hoarse voices get back to normal relatively quickly.
In a study of 22 people with chronic laryngitis, the acid-suppressing drug Prevacid, taken twice a day, cured laryngitis signs and symptoms in 50% of people who took it, reports the study's lead author Hashem B. El-Serag, MD. Only 10% of people who took a look-alike placebo got similar results.
The study, reported in the April issue of the American Journal of Gastroenterology, supports the idea that stomach acid plays a major role in causing chronic laryngitis. Prevacid is used to treat gastroesophageal reflux disease, also known as GERD, a condition in which stomach acid abnormally splashes up into the esophagus and into the back of the throat, causing discomfort and pain.
Prevacid is one of a class of agents called proton pump inhibitors, or PPIs, that decrease the amount of acid produced in the stomach. Proof that Prevacid works in at least some people with chronic laryngitis suggests the condition is related to an abnormal acid reflux condition and/or GERD.
According to El-Serag, assistant professor of medicine at Baylor College of Medicine, in Houston, people in the study had a high likelihood of having GERD, but that does not mean all cases of chronic laryngitis are GERD-related.
Still, a proportion of people may have acid reflux as the main cause of their laryngitis and doctors who specialize in ear, nose, and throat problems should always be on the lookout for it, says Michael Setzen, MD, a physician in private practice in Manhasset, N.Y., and a member of the American Academy of Otolaryngology-Head and Neck Surgery.
Stomach acid that refluxes can bathe the vocal cords and affect your voice, he says. Prevacid or one of the other proton pump inhibitor drugs -- such as Prilosec, Aciphex, Protonix, and Nexium -- may help by limiting the amount of acid being produced.
"The possibility exists that some of those people with chronic laryngitis may have [acid reflux] and therefore proton pump inhibitors may assist those patients," says Setzen, who is also clinical professor of otolaryngology at New York University and New York Medical College. "And even second-hand smoke can be a factor in some cases."
Still, Setzen says, because chronic laryngitis and/or hoarseness can be a sign of potentially serious medical problems, including polyps and cancers of the larynx or esophagus, it should never be taken lightly. Most experts agree that if laryngitis lasts for more than a couple of weeks it's important to be seen by a doctor.