Acid reflux occurs when acidic stomach juices back up from the stomach into the esophagus. There are two different kinds of acid reflux: GERD and LPR. The most typical symptoms are heartburn, indigestion and regurgitation.

This is something that happens, even with the healthiest diet. If you bend over at the wrong time, you may have some gastric content reflux up near your esophagus. Your esophagus is resilient to a certain amount of reflux.

However, your larynx reacts differently. Imagine how different body parts react to acidic substances. For example, lemon juice on your tongue will evoke taste but lemon juice on the eye will cause a burning sensation. Similarly, stomach acid affects your larynx differently than your esophagus. When small amounts of acid comes into contact with your larynx, it often causes throat clearing, excessive mucous, or a lump in throat sensation called globus.

But could acid reflux be the cause for your voice to change?

We turned to Dr. Michael Johns, III, MD, professor of clinical otolaryngology – head and neck surgery, division director of laryngology and director of the USC Voice Center to get the answer.

According to Dr. Michael Johns, it is very unlikely.

Voice symptoms can occur with reflux, but usually it takes a lot of reflux to cause enough inflammation to injure your vocal cords and change your voice. In the absence of having other symptoms like heartburn and a persistent cough on top of acid reflux, the likelihood of acid reflux being the diagnosis for someone’s voice change is extremely low.

More often than not, the root issue is something completely different.

Your voice is controlled by your vocal cords.

We make healthy clean sounds by having soft, pliable vocal cords. The primary function of the larynx (also known as the voice box) is to protect the airway. It protects by closing it off. When you swallow, your larynx closes off. Food can then pass into your esophagus without aspiration. When patients have voice changes, there’s a problem with their vocal cords.

The symptoms have a wide range.

If your voice is changing, it is probably due to the abnormalities of your vocal cords and the ability for them to vibrate in a regular way. Sometimes, this is due to a benign or malignant growth on the vocal cords. Changes in your voice may be due to vocal cord nodules, cysts, acute laryngitis, vocal trauma, or muscle tension in the voice box.

If your voice changes last longer than two weeks, you should be evaluated be a n otolaryngologist – ideally one specialized in voice, like our team at the USC Voice Center.

Many people are misdiagnosed.

Voice changes in isolation of any other symptom are unlikely to be related to acid reflux. Yet, it is very common that patients will go into see an ENT (ear, nose, throat) doctor with voice symptoms that are isolated and the doctor may not have enough training, expertise, or the diagnostic capabilities to secure a firm diagnosis. Most end up saying that you have reflux and put you on an acid suppression medication. With no surprise, it doesn’t help.

That is due to misdiagnoses.

A thorough diagnosis is the answer.

Acid Reflux very rarely causes voice change. A detailed laryngeal endoscopy is the answer. There’s nothing to fear though, as you won’t be sedated. This painless simple procedure is done when you are awake. It’s so simple that Dr. Johns does it on himself.

When our doctors evaluate patients who come in with voice changes at the USC Voice Center, they visualize the vocal cords in detail to look for anomalies and abnormalities in the vocal cords themselves. Through this process, they are able to get a solid diagnosis by seeing vocal cord vibration.

How the diagnosis is performed.

If your voice is changing, then you need to see an otolaryngologist and have a detailed examination. Our physicians use specialized equipment called laryngeal videostroboscopy. They flash a strobe light while the patient is making sounds. This way, vocal cord vibrations can be seen in slow motion. That gives our team the key diagnostic information necessary to figure out exactly why the patient’s voice is hoarse.

The resolutions.

Depending on what the underlying issue is, there are many treatment options. These range from medication, behavioral therapy, voice therapy and occasionally surgery.

Why Keck Medicine of USC.

Speaking is a physical task. It is like walking, running or throwing a ball. Because of that, you will need a team to take you through recovery. At the USC Voice Center of Keck Medicine of USC, we have an interdisciplinary team, consisting of voice specialists, a laryngologist, a singing voice specialist and speech pathologists that are specialized in voice and behavioral rehabilitation.

At the USC Voice Center, you will not be limited to just seeing one clinician. You will also be seen, together at the same time, with a speech pathologist that is an expert at voice rehabilitation. This way, you will get a thorough diagnosis that can lead to the groundwork to the road to recovery.

To learn more about USC Voice Center, visit

To schedule an appointment, call (800) USC-CARE (800-872-2273) or visit