Laryngitis

Laryngitis

You may have heard that as you age, the muscles in your body can get weaker over time. That’s not just true of the muscles in your arms and legs, but in all of your muscles, even the ones you don’t think about, such as the ones in your throat.

Your larynx or voice box, for instance, is made up of muscles. As you age, they can weaken and change shape. The same is true for your vocal cords. Consequently, when you get laryngitis (an inflammation of the larynx that makes your voice go hoarse and raspy), your weaker throat muscles may take longer to bounce back from the inflammation. Doctors even have a name for this problem. They call it presbylaryngis, which simply means an aging larynx.

“In general, older people will get problems with their cords more easily than other age groups and the problems might last longer. As people get older, the cords themselves are a little bit weaker and a little bit bowed,” says Gregory Grillone, M.D., otolaryngologist and director of the voice center at Boston Medical Center.

Some diseases that can affect seniors’ voices are Parkinson’s disease and diabetes. But for most people, laryngitis has commonsense causes. If you get a simple viral infection such as a cold, it can affect the larynx. If you let loose with a holler at your granddaughter’s soccer game, your vocal cords may get the sensation that you’re out to beat them. And then there are people who chronically abuse their voices because they overuse them professionally, such as some teachers, singers, or lawyers.

A surprisingly common cause of laryngitis that is not as well known is gastrointestinal reflux (heartburn), which happens more frequently as you age. Reflux occurs when some contents of your stomach—including very harsh digestive acids—back up into your esophagus. The acids from the stomach cause irritation and laryngitis. “It’s the most common reason I see for voice problems,” Dr. Grillone says.

Whatever has made you hoarse, though, doctors recommend the following strategies for getting your voice back in shape.

Try This First

Liquefy your larynx. A phrase used among voice doctors and professional singers is “pee pale,” Dr. Grillone says. Singers know that if their urine is not clear like water, they’re not drinking enough water. And drinking enough water is a major part of good vocal hygiene. Drinking water keeps the secretions in the throat thin and mobile as well as helps the whole body with the healing process. So polish off at least eight, eight-ounce glasses of water a day.

Other Wise Ways

Keep mum. Getting through a day without talking can be difficult. But when you have laryngitis, what you need is a respite for your larynx and vocal cords, states Marshall Postman, M.D., allergist in private practice in Reno, Nevada. “If you had tendonitis, you would try not to use the joint that tendon was affecting, so with laryngitis, really the best thing is to get vocal rest,” Dr. Postman advises.

Don’t even whisper. People think that whispering doesn’t count as talking. But whispering is very straining and in no way saves the voice, warns Florence B. Blager, Ph.D., professor in the department of otolaryngology at the University of Colorado School of Medicine and chief of speech pathology and audiology services at National Jewish Medical and Research Center, both in Denver. When you whisper, your larynx tightens with a great deal of effort as your breath comes through a very constricted laryngeal area. This causes strain, and the louder you try to whisper, the greater the constriction and the more the strain on your vocal cords.

Write it down. Carry a pad and pen or pencil with you so you can still communicate, Dr. Blager says.

Avoid irritating environments. Don’t go to places where smoke or fumes that you inhale may irritate the larynx further, Dr. Blager recommends.

Be smart about cheering the home team. Dr. Blager has studied the strain and damage that cheerleaders can cause to their voices. “You overuse the cords, and, yes, you can ruin the vocal cords forever,” Dr. Blager says. She advises people to not shout themselves hoarse at a sporting event. If you want to cheer for your team, give your voice some support. “Roll up your program and use it as a megaphone so you get a lot of intensity increase without shouting. It lets you feel that you’re really contributing,” Dr. Blager says.

Put your voice in the right place. With an illness such as flu, you can become tired and weak, and your breath can become shallow. When this happens, it takes effort to keep your voice forward. Even after the illness is gone, the shallow breathing pattern can remain, causing you to speak from deep in your throat, Dr. Blager says. That can cause hoarseness after just a couple of weeks. It may be necessary to relearn how to breathe and get your voice forward again, Dr. Blager says. Focus on breathing from your abdomen, not from your chest, and focus your voice in the front of your face, not in your throat.

Strengthen your voice. One way to strengthen your voice, Dr. Blager suggests, is to practice extending your exhale up to 15 to 20 seconds. Two or three times a day, make a conscious effort to breathe out steadily on an “s” sound, while you time yourself or silently count the seconds. And concentrate on talking while you exhale. This helps you avoid straining your throat by speaking after all your breath is exhaled.

Get a little humidity. Using the power of humidity is also a good way to keep your airways moist and your secretions moving, says Anne L. Davis, M.D., associate professor of clinical medicine at New York University in New York City. You can give yourself a humidity treatment with simple kitchen equipment. Heat a large open pan of water until it’s boiling, and remove it from the stove. While it’s still busily steaming, take it to the table, drape a towel over your head, hang your head over the pot, and inhale deeply. Keep your eyes closed and don’t get so close that you burn your skin. Steam for 5 to 15 minutes.

Go for a soothing feeling. Suck on a hard candy or drink warm lemon and honey. These remedies can soothe a raw throat, Dr. Davis suggests.

Take an antacid. If you suffer from reflux, a common cause of laryngitis, take antacids such as Mylanta and Maalox and acid reducers such as Tagamet and Pepcid AC. These can help reduce nighttime gastroesophogeal reflux, a backing up of the stomach’s contents into the esophagus, Dr. Grillone says.

Eat wisely. If reflux laryngitis is your problem, there are some things to consider about when and what you eat. “There are a lot of things that people do in their diets or their day-to-day habits that make reflux worse,” Dr. Grillone explains. Make your last meal of the day light and eat it at least three hours before bedtime.

Guard against reflux producers. Avoid alcohol, tobacco, caffeine, and mint or menthol, which all stimulate gastric acid and encourage reflux, says Dr. Grillone. Stay away from carbonated beverages, because the carbonation bloats your stomach and as it does, it puts pressure on the valve between your stomach and esophagus that is supposed to keep reflux from occurring.