Hard to Swallow: The Risk of Reflux

By: Julia Iszler, Heather Smythe, and Jingchen Xu

Many people experience sensations of something stuck in their throat when they have acid reflex.

Laryngopharyngeal Reflux (LPR) is when acid from the stomach travels all the way up the food pipe (esophagus) and into the throat and voice box (laryngopharynx). This backflow of stomach acid can cause irritation and swelling to the vocal folds, which can negatively impact your voice. Common symptoms of LPR include sore throat, frequent throat clearing, a sensation of a lump in the throat, and voice changes such as a mild hoarseness. LPR can be difficult to diagnose, as there is no gold-standard for testing to see if a patient has it. Nearly half of patients with voice complaints who are referred to an ear, nose, and throat doctor (ENT) are diagnosed with LPR (Patel et al., 2018).

What are Common Risk Factors?

There are two common risk categories–the inevitable and the preventable. Older age is an inevitable risk factor, however there are several factors linked to lifestyle and diet, prevention measures of which are discussed below. Those include obesity, smoking, and sedentary lifestyle (Clarrett & Hachem, 2018).

What Can I Do?

Techniques for preventing reflux have a lot to do with lifestyle and diet. A simple step you can take, without needing a prescription or diagnosis, is to cut back on certain foods or beverages. Reducing consumption of caffeine and alcohol, for instance, is a good place to start. This may look like eliminating them from your diet altogether, or, less drastically, switching from four cups of coffee to one per day, or one caffeinated and one decaffeinated cup. Another preventative measure is reducing your consumption of fatty, greasy, spicy, and acidic food. The benefits of following through with such reductions are multi-faceted. Not only do they reduce the risk of LPR, but they can also contribute to an overall healthier lifestyle.

Alongside diet changes, eating habits as a whole may also be targeted. Good rules of thumb for the fight against reflux include reducing the size of meals, as consuming large amounts at one time increases the chances of post-meal reflux. It is also best not to eat at least three hours before going to bed, giving your body time to digest and aid gravity in its work to keep things in the stomach. In that same line of thought, when sleeping, it may be beneficial to keep the head of the bed slightly elevated, or use a special “reflux pillow.”

Ultimately, reflux is very common, and knowing the signs and symptoms of LPR, as well as making lifestyle changes to help prevent reflux, can be very beneficial to maintaining good vocal hygiene and potentially help you feel better overall!


Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal Reflux Disease (GERD). Missouri medicine, 115(3), 214–218.

Patel, D. A., Blanco, M., & Vaezi, M. F. (2018). Laryngopharyngeal Reflux and Functional Laryngeal Disorder: Perspective and Common Practice of the General Gastroenterologist. Gastroenterology & hepatology, 14(9), 512–520.