Smoking: Smoking is another cause of hoarseness. The structures in the throat (pharynx, larynx, and lungs) are much more sensitive to stomach acid and digestive enzymes, so smaller amounts of the reflux into this area can result in more damage. Laryngopharyngeal Reflux (LPRD): If the reflux makes it all the way up through the upper sphincter and into the back of the throat, it is called LPRD rather than GERD. These people may have a sensation of a lump or mucus in their throat and have an excessive desire to clear it. Usually, the voice is worse in the morning and improves during the day. Many patients with reflux-related changes of voice do not have heartburn. Gastroesophageal Reflux (GERD): A common cause of hoarseness is gastro-esophageal reflux, when stomach acid comes up the swallowing tube (esophagus) and irritates the vocal cords. It is considered a vocal emergency and should be treated with absolute voice rest and examination by an otolaryngologist (ear, nose, and throat doctor). Vocal cord hemorrhage occurs when one of the blood vessels on the surface of the vocal cords ruptures and the soft tissues fill with blood. Vocal Hemorrhage: If you experience a sudden loss of voice following a yell or other strenuous vocal use, you may have developed a vocal cord hemorrhage. Vocal cord polyps and cysts also occur in those who misuse their voice, but can also occur in those who do not. Vocal nodules (singers’ nodes) are callus-like growths of the vocal cords. These habits can lead to nodules, polyps, and cysts.
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