The Real Reason you are Constantly Hoarse

The Real Reason you are Constantly Hoarse

If you have ever suffered from a bizarre sore throat that constantly makes you hoarse it could be difficult to properly diagnose. Believe it or not this mysterious hoarseness could be related to acid reflux.

Yes, acid reflux.

The acid travels the whole way up the esophagus and enters the throat and the voice box. This is where the acid will irritate and inflame the vocal cords which can leave you feeling hoarse and sometimes with other throat problems.

Understanding More About This Type of Acid Reflux

This problem is directly linked to a condition called Laryngopharyngeal Reflux or LPR for short. The main problem for someone who has LPR is primarily revolving around the throat area. Someone who has a small nagging problem with their throat and things like hoarseness could possibly be the early signs of LPR.

Sometimes LPR is also called silent reflux – this is because someone who has LPR has reflux although they typically won’t have any other of the more typical reflux symptoms like heartburn. Therefore, for the average person to identify that the problem could be related to acid reflux is very difficult because they don’t have the common reflux symptoms.

Some of the common symptoms for someone with LPR are – hoarseness, burning in throat, chronic cough, throat clearing, lump in throat feeling etc.

Proper Diagnosis

Recognizing that your problem is related to acid reflux could be very difficult for even a doctor to diagnose. If you went to a doctor and explained your symptoms they may think of a host of possible causes, but it would be difficult to pin point it directly to acid reflux. This is somewhat of a problem for doctors and physicians alike that they simply aren’t well enough educated about LPR and how exactly it works.

This is partially because LPR is somewhat of a new problem that has arisen in recent years and research and education on LPR is generally quite low.

Most doctors in fact treat LPR as if it where the more typical kind of reflux called GERD (Gastroesophageal reflux disease). The problem with this approach is that what is effective for treating GERD is not effective for treating LPR most often.

Silent Reflux is More Common Than You Think

You might have thought that this kind of reflux is quite rare, but that assumption would in fact be wrong. It is estimated that 10-20% of Americans suffer from silent reflux. Though for a lot of them they will never know that it is in fact related to acid reflux.

Luckily for many people who have the problem it will only be very minor and rarely will happen. Though for others they may have a more consistent problem whether that is a sore throat or general hoarseness. For both sets of people it is definitely worth considering that it could be acid reflux affecting you.

Stopping and Preventing LPR (silent reflux)

Luckily if you do have this kind of reflux it is possible to get it under control and get your throat problems back to normal and as they should be. Below I am going to list some of my top pieces of advice that you should follow to help address this problem.

#1 Avoid Overeating

One of the most important things to help stop silent reflux is to not overeat. When I say overeating I mean to not eat too big of a portion at one time. The reason for this is if you do overeat you put your stomach under more pressure and more importantly the valve above the stomach called the lower esophageal sphincter (LES). If you didn’t know the LES is designed to close over and tighten when there is food in the stomach being digested. For someone with LPR this often means an LES than is opening too often.

When the LES valve is under more pressure, then it is more prone to relax and open which then would end up in acid refluxing up. For a lot of people this overeating process can in fact bring on reflux in the first place. This is because someone who overeats constantly over a period of months/years puts a constant pressure on the LES which causes it too degenerate over time. Therefore, some people can develop this sore throat somewhat out of nowhere.

Luckily the easy solution to this is to eat smaller meals. You shouldn’t eat more than the stomach can hold at one time which is about the size of your fist. Keep in mind this doesn’t mean you should eat less throughout but just more smaller meals each day instead of fewer larger meals. Luckily if you start to eat smaller portions not only will your symptoms start to fade away but the LES should start to heal and return to normal function.

#2 Avoid Eating Before Bedtime

If once in a while you wake up with a random sore throat this could be because of your eating habits the night before. If you eat soon before bedtime this can be a problem.

The problem with this is that if you eat and then lay down after you don’t have the advantage of gravity keeping the acid and food down in the stomach and this adds more pressure to this LES valve above the stomach. More pressure means more likelihood of reflux which is exactly why you should avoid eating before bedtime.

Ideally you want to avoid eating 3 hours before bedtime at least. So, if you eat at 7pm you shouldn’t sleep (lay down) until 10pm at the earliest. This time allows for the stomach to digest all of the food and to fully empty before sleeping.

#3 Avoid Acidic Foods/Drinks

One thing you may have already thought of helping with acid reflux is too avoid more acidic foods and drinks. Consuming less acidic foods simply will lower reflux because of the lower acid intake. Not only does avoiding most acidic foods/drinks lower reflux but because acidic things passing over the throat can directly irritate it avoiding them should help the throat heal more easily.

There are a host of foods and drinks that are top of the list that you want to be avoiding, they are – spicy foods, fatty foods, deep fried foods, citrus fruits, tomatoes, raw onions, peppers, alcohol and soda drinks.

#4 Avoid Chocolate and Caffeine

Not only can acidic things be a problem but there are also other things that are not acidic which can have a negative effect. The 2 things that are most important to mention are chocolate and caffeine.

The problem with these is that they can directly cause the LES valve above the stomach to relax and this too can induce reflux problems.

#5 Eat a More Alkaline Diet

Someone who may suffer more seriously from a sore throat that is caused by acid reflux should ideally do an alkaline style diet. Ideally you want to follow a diet that is more alkaline because of a thing called pepsin.

Pepsin is a digestive enzyme in the stomach which is used to help digest proteins in the stomach. When you have acid reflux it also comes up with the acid – the problem with this is that it causes damage and inflammation in the throat area.

A notable thing worth mentioning with pepsin is that if it comes in contact with something more acidic it reactivates more causing more damage in the throat area – this is because it is meant to be in the stomach where it is highly acidic and where it should be activated.

Therefore, the more alkaline the foods and drinks you consume the less it is activated and the less harm it will do. So, therefore eating a diet that is more alkaline will prevent this from happening.


Though a small problem for some and a more significant problem for others this hoarseness mystery is after all related to acid reflux. Luckily with the tips previously suggested you can stop it and prevent it from happening in the future and get everything back to normal!

About the Author

David is a blogger at Wipeout Reflux where he covers everything acid reflux with a more prominent focus on silent reflux. He also has a complete LPR guide where he covers everything about LPR (silent reflux) including causes, symptoms and treatment.