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Voice - stomach acids may have low odor

23 Mar 04 - 01:05 PM (#1143990)
Subject: Voice - stomach acids may have low odor
From: steve in ottawa

I've just scanned the hits for "reflux" and maybe this is belaboring a point a little, but here goes:

If the little muscle at the top of your stomach opens up now and then, the acids can get up your esophagus to your throat. They almost never smell like vomit, so you might not notice. If they don't hang around for very long, they won't damage your esophagus (causing heartburn), because your esophagus is much sturdier than the top of your throat. But your upper throat, including your vocal chords, will take some damage.

The term for this is LARYNGOPHARYNGEAL REFLUX (LPR).

I've just been diagnosed with mild LPR. It'll be a major pain to get rid of it/control it, but it will be worth it, because it took the fun out of singing for the past 18 months (and hence, I've dropped from 10 hours a week to near zilch). I'd heard of reflux a zillion times, but thought THAT can't be my problem becasue I didn't know (once again):
reflux can damage your upper throat with damaging your esophagus.
stomach acid doesn't have to smell like vomit.

I hate going to doctors, but in this case, seeing an ear-nose-throat specialist was worth it.


23 Mar 04 - 02:25 PM (#1144069)
Subject: RE: Voice - stomach acids may have low odor
From: Sooz

What are you taking for it? I've been prescribed a proton pump inhibitor but I don't like the look of the contra-indications. It does seem to be helping the voice though.


23 Mar 04 - 06:01 PM (#1144271)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

Pretty well nothing. Behaviour modification -- lots of that. I had no idea coffee was such a big part of my life. Specific tummy drugs? Just a couple of Tums and a glass of water before sleeping. It's been less than a week. The doc was more interested in my nose -- I've always had problems breathing through my nose; forty years old and only now do I find out my septum is deformed resulting in my left nostril being kind of small. It was only the increasing pain in my throat that finally taught me how to unconsciously breathe through my nose while sleeping -- a new behaviour which really helped my throat cope with the reflux for a several extra months.

Now I'm sleeping on an inclined bed (head propped up about six inches) which keeps stomach acids in my stomach, and POW! right away I'm waking up breathing through my mouth every other morning.
Argh! I *think* my throat is getting better. I've found myself singing when doing chores again. But maybe it's just spring. My throat never got consistently bad enough that I couldn't sing; it just took the joy out of singing.

I've got a water-based misting nose-spray and an anti-allergy nose-spray, both of which I haven't started using yet. Food changes were enough for the first week. Food changes are TOUGH. I'm even supposed to reduce tomatoes and citrus as much as possible. Woh.

My main point in posting was: to let people know that acid reflux could get hit their throats without being obvious about it. And one other thing: when your throat and voice box get sore, the soreness can soon radiate out, because the muscles around it tense up and themselves eventually get sore. Seems obvious in hindsight, but I started to really worry when my the soreness seemed to be spreading out right over to my shoulder...

My own pet theory now is: I drank SO much water to cope with dry-throat due to breathing through my mouth that I filled my stomach too much, too often, which weakened the valve at the top of my stomach's ability to hold down the contents, which washed up my esophagus occasionally, but which were very weak because of all the water...oh heck...just make sure you see a doctor if throat problems persist over a couple of months. Don't wait a year and a half like me.


23 Mar 04 - 06:19 PM (#1144289)
Subject: RE: Voice - stomach acids may have low odor
From: Liz the Squeak

Hmm... maybe propping our bed up might help Manitas and his problems, the biggest for me being his snoring... got some bricks in the garden....

He's been having trouble with his stomach too...

Thanks for the info, it might be a lifesaver - insomnia is bad enough but when your partner is comatose and snoring like a buzz saw, it's just downright insulting!

LTS


24 Mar 04 - 06:40 AM (#1144680)
Subject: RE: Voice - stomach acids may have low odor
From: Strollin' Johnny

Steve, you have my sincerest sympathy - I get it and it's no joke. I have raging heartburn (to a point where eating is extremely painful), and I wake in the night choking when the acid's crept up my oesophagus and into my windpipe - can't breathe and it burns like hell!

Like you, I was advised by my doctor to cut back radically on alcohol, tea and coffee consumption (no problem losing the coffee and alcohol but reducing tea consumption's a real bummer!) and avoid fruit juices (damn!) and eating fatty foods in the evening. I usually drink a glass of water and take 'Rennies' before bed, that seems to control it.

And yes Liz, Mrs. Johnny assures me that I can snore for England!

Apparently it's a common problem, more so than you would expect.

Johnny :0)


24 Mar 04 - 09:10 AM (#1144778)
Subject: RE: Voice - stomach acids may have low odor
From: Steve Parkes

There's been another thread(s?) related to gastric reflux (GR), I think. I have a hiatus hernia, where the oesophogeal sphincter has moved up through the diaphragm and ... after that it gets gruesome!

The only answer (unless it's life-threatening, in which case you can have surgery) is don't eat or drink anything within several hours of going to bed (only trial and error will determine how many; it's about three or four for me), and in particular, ease off on caffeine, alcohol, chocolate, nicotine ... and try to find a reason to continue living!

I also snore a lot, due to constricted nasal pasages. I had surgery for that, but it gradually got worse again. Snoring is life-threatening -- if you share a bedroom. Alcohol makes it worse, by relaxing the musces more (and that goes for the GR too), even after a measly pint at lunchtime (which makes me all the more wary of the dangers of drinking and driving, even if ever so little the night before). Sleep apnoea is bad for you, as it deprives you of oxygen; it can cause death if you're really unlucky, even if you don't have a partner who's tempted to hold the pilow over your mouth. It can make you dribble in your sleep too, which is pretty yucky in itself, but it can also lead to a heavy build-up of plaque on your teeth: unsighlty and expensive to have removed.


I think it's only the singing that makes it worth carrying on!

Steve


24 Mar 04 - 12:53 PM (#1144957)
Subject: RE: Voice - stomach acids may have low odor
From: TheBigPinkLad

Steve -- This is folklore so heed with caution, but you might find as I did that the pain is caused by a lack of acid rather than an excess; i.e. your stomach is too alkaline. Try a tablespoon of cider vinegar (real stuff, not a cheap fake) in a glass of water three times a day for a week. If you get gyp after the first dose, desist, of course.

Oh, and call me in the morning.


24 Mar 04 - 01:28 PM (#1144989)
Subject: RE: Voice - stomach acids may have low odor
From: Sooz

The proton pump inhibitor stops you making stomach acid rather than neutralising it. It seems to work but it isn't a permanent solution.


24 Mar 04 - 01:59 PM (#1145013)
Subject: RE: Voice - stomach acids may have low odor
From: Barbara

Steve, sleep apnea can also be life threatening because the lack of oxygen (caused by not breathing regularly while snoring) raises your blood pressure and can cause a stroke or heart attack. It happened to a friend of mine -- someone in their 50's.
Blessings,
Barbara


24 Mar 04 - 04:40 PM (#1145158)
Subject: RE: Voice - stomach acids may have low odor
From: Justa Picker

Losec works great.
Also, have an abdominal ultra sound and check for gallstones.


(I am not a doctor nor do I play one on television. :-)


24 Mar 04 - 07:13 PM (#1145285)
Subject: RE: Voice - stomach acids may have low odor
From: Liz the Squeak

Ah, well I seem to have cured the possibility of sleep apnoea - I don't sleep! Well, not recently. I appear to have given it up for Lent.

LTS

(who is clearing out the cellar tomorrow looking for suitable blocks for the bed!)


25 Mar 04 - 04:25 AM (#1145559)
Subject: RE: Voice - stomach acids may have low odor
From: Dave the Gnome

The proton pump inhibitor stops you making stomach acid rather than neutralising it. It seems to work but it isn't a permanent solution.

It seems to be for me! (Permanent that is.) 10 years now and counting. Moved from Omaprazole (Losec) to Pantaprazole last year but no ill effects to date:-)

Mine is Hiatus Hernia but I also have perenial alergic rhinitus for which I take anti-histamines, a nasal steroid and a sea-water mist spray. It was asthma that brought on the hernia btw.

I'm just a wreck aren't I! Doesn't seem to have affected my voice or beer capacity though...

Cheers

DtG


25 Mar 04 - 06:09 AM (#1145604)
Subject: RE: Voice - stomach acids may have low odor
From: Steve Parkes

"... looking for blokes for the bed," Liz?!

Mine is definitely acid, BPL! I've had the HH since I was a, well, small pink lad; inherited from Mom (but forunately skipped the colitis, arthritis, ankylosing spondulitis and a few other things she wouldn't thank me for mentioning). The SA is relatively new (since 40s; I'm now 50-something). Recently saw a specialist about the snoring; without another operation (which I'd prefer to avoid) there's not much they can do. I use a nasal splint at night, which helps a bit (made by Nozovent; also stick-on jobs are not bad), and he got me to try a steroid spray, which makes breathing even more easy (but doesn't make much diference to the snoring). Next thing to try is a thing-that-goes-in-your-gob-to-keep-it-shut, which I'll have to ask my dentist about. I'll keep you posted, but don't hold your breath (no pun intended!)

I don't worry about strokes (if I can avoid it!); one of my grandmothers had one at 60-ish, but by and large most of our family have managed a good many years without much trouble. (They didn't grow up with tv and Big Macs, of course, but then neither did I.)

Steve


25 Mar 04 - 06:27 AM (#1145616)
Subject: RE: Voice - stomach acids may have low odor
From: Pied Piper

This is definitely the thread for me as I have Gastric reflux and sleep aponea (oh and dyslexia).
I'm on Zoton a similar drug to Dave that I take once a day. Every now and then I stop taking it and the asophogitis comes back.
I know when I have to go back on when I get that pain in the shoulders (mostly right in my case).
For the Apnoea I have a CPAP machine that maintains a positive pressure in my throat through a facemask.
Both these conditions are adversely affected by being over-weight so I've reduced from 16.5 Stone 14, and I'm hoping to reach my target weight of 12 Stone by the beginning of next year.

TTFN
PP


25 Mar 04 - 06:41 AM (#1145623)
Subject: RE: Voice - stomach acids may have low odor
From: Strollin' Johnny

Piper, you must be my long-lost twin brother! How did you come by the Sleep Apnoeia gadget and was it dear? I'm getting worried as it seems to be happening more and more often - I sometimes wake up feeling very breathless (and it's nothing to do with nocturnal activities with Mrs. Johnny!) and it's pretty scary stuff.
Johnny :0)


25 Mar 04 - 08:35 AM (#1145702)
Subject: RE: Voice - stomach acids may have low odor
From: GUEST,Sooz(at work)

Dave - I hate the thought of taking any medication over an extended period. The Zoton upsets my guts and isn't a total solution to my voice problem. What I need is early retirement! (The sooner the better)


25 Mar 04 - 08:52 AM (#1145715)
Subject: RE: Voice - stomach acids may have low odor
From: Strollin' Johnny

Don't we all! :0)


25 Mar 04 - 11:20 AM (#1145834)
Subject: RE: Voice - stomach acids may have low odor
From: Pied Piper

I got the CPAP machine after I was sent to the Sleep Clinic at Wythenshawe Hospital (Manchester UK) by my GP.
They gave me a device that records the level Oxygen in your blood (optically no needles) to use as I slept. When the information was processed it showed that I was waking up 30 times a night with low blood Oxygen levels. I got the machine the next week.
Your symptoms seem very similar to mine; I would go and see your Doc about getting checked out.
Personal question but are you over-weight?

TTFN
PP


25 Mar 04 - 11:26 AM (#1145844)
Subject: RE: Voice - stomach acids may have low odor
From: Strollin' Johnny

Absolutely! Weight's a long-standing problem and I know it's doing me no good. I didn't snore at all until about 5 years ago, when I started to pile weight on. I've suspected that it's at the root of the sleep problem and also the acid-reflux jobbie.

Thanks for the info. I'll try to lose weight (again) and see the quack.

All the best.
Johnny :0)


25 Mar 04 - 12:37 PM (#1145930)
Subject: RE: Voice - stomach acids may have low odor
From: CarolC

I use digestive enzymes when I've eaten protein or fats. If I didn't do that, I would probably have a hole in my stomach by now. I eat a piece of dried papaya (about an inch long) when I've eaten fats or hard to digest non-protein foods, and I take 1/4 of a digestive enzyme tablet that includes:

Pancreatin
alpha-Amylase
Betaine Hydrochloride
Pepsin
Papain
Ox Bile Extract 8:1

...when I've eaten protein. Works like a charm, and I can still have one cup of coffee a day. And there are no side effects.


25 Mar 04 - 12:41 PM (#1145937)
Subject: RE: Voice - stomach acids may have low odor
From: GUEST,Arkie

I've done the sleep clinic and CPAP and finally quit the CPAP because I did not like the noise, the thing on my face, and tangling up with the tube. Now that my hearing is shot the noise would not be much of an issue. I understand there have been improvements in the CPAP. And I think it did actually help to some degree. I cannot remember the cost, but my insurance took care of that.


30 Mar 04 - 12:00 AM (#1149618)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

Latest news: yep, changing eating habits is tough.

Re: propping up the head of the bed 6 inches

If you want to try this (using gravity to keep acids in your stomach while sleeping) try different heights. 3.5 inches did not work for me. 6 does. Some web sites recommend 8-10 inches. Regardless, the first few times it will feel about twice as big as it is. (insert joke here). Slanty beds are damn strange. But they may help you.

Trial with bricks or books is fine, but be prepared to make something permanent that will stay in place even if you swing the bed around.

Extra pillows won't work. A wedge of foam that won't move around will work. (Search "GERD pillows" on the net). A wedge of foam is easier to remove quickly if you don't want your bed to look strange, and may be more acceptable for a sleeping partner 'cause you can get 'em for just half the bed.

And it's amazing how many different views there are out there regarding what foods to eat/not eat while fighting acid reflux. The prime view usually is: don't experiment too much until you've healed as much as you can heal. Step down from maximum. Don't step up slowly towards maximum.

I'm also hoping that walking at a relaxed pace after eating might help (and yes, I know *real* exercise would be bad, bad, bad). And I forgot all about not eating late in the evening today. Rats.

And hey, BigPinkLad, I'll think upon the too-alkaline idea and maybe try it. Thanks for the info. My hunch is that for me, the problem is acid, mostly because that's more common, and because skim milk in my throat feels great. A few seconds after finishing too much skim milk, I had a high-power burp that seemed to coat the entire inside of my larynx and it felt...wonderful and cool.


30 Mar 04 - 12:50 AM (#1149629)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

I think I just understood some people's posts:

The inclined-bed thing only has to do with stomach acids. I don't think it would affect most people's breathing.

It may have affected my breathing because stomach acid in my throat caused problems that were aggravated by breathing through my mouth. Slowly, the discomfort caused by the acid's damage taught me to breathe through my nose. Recently, I've woken up with a dry mouth four times. I speculate that it's because it there's less discomfort now from breathing through my mouth. But it may be simply that some allergy clogged my nose in the night.


30 Mar 04 - 06:35 AM (#1149812)
Subject: RE: Voice - stomach acids may have low odor
From: GUEST

i am 45 and have noticed this problem with my singing... then the doctor told me about acid reflux... now I have the inclined bed the losec.. the incredably hard not eating before sleep... I loved to do that...
Is it curable ? is it something I will have to live with until I die?


30 Mar 04 - 03:13 PM (#1150313)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

Probably this is something we'll have to keep in mind for the rest of our lives.

Something interesting from an article someone sent me:

Mild reflux, 5.5 year study
11% got worse
60% had relapses now and then or stayed the same
29% got better with no further episodes

One hundred and five patients with mild RE were followed, without medical treatment, by endoscopy in addition to a questionnaire regarding symptomatology, for a mean of 5.5 years (range, 2.0-8.8 years) after initial diagnosis. Factors associated with the development of severe esophagitis were analyzed. RESULTS: Endoscopically, 11 patients (10.5%) progressed to more severe forms of RE (recurrent progressive (RP) group), 60.0% of patients relapsed without disease progression (recurrent non-progression group), and the remaining 29.5% of patients had no further episodes of RE (isolated episode group).

The full summary:
Clinical characteristics and natural history of patients with low-grade reflux esophagitis.

Manabe N, Yoshihara M, Sasaki A, Tanaka S, Haruma K, Chayama K.

Gastrointestinal Unit, First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.

BACKGROUND AND AIM: Although the incidence of reflux esophagitis (RE) has recently increased in Japan, the majority of these cases are mild (Los Angeles classification grades A and B). In order to consider therapy for these patients, it is important to understand the natural history of mild RE. There is little information concerning the natural course of RE, particularly low-grade disease. The goal of this study is to elucidate the natural course of patients with mild RE and to identify specific prognostic indicators associated with a poor outcome. METHODS: One hundred and five patients with mild RE were followed, without medical treatment, by endoscopy in addition to a questionnaire regarding symptomatology, for a mean of 5.5 years (range, 2.0-8.8 years) after initial diagnosis. Factors associated with the development of severe esophagitis were analyzed. RESULTS: Endoscopically, 11 patients (10.5%) progressed to more severe forms of RE (recurrent progressive (RP) group), 60.0% of patients relapsed without disease progression (recurrent non-progression group), and the remaining 29.5% of patients had no further episodes of RE (isolated episode group). Risk factors for progressive disease were increased age, female sex, the presence of symptoms at initial diagnosis by endoscopy, presence of a hiatal hernia, absence of atrophic gastritis, and absence of Helicobacter pylori infection. Despite having all risk factors, there were six patients who did not progress to more severe forms of RE. The primary esophageal peristaltic amplitude in these patients was significantly higher than in the RP group. CONCLUSIONS: Among patients with mild RE, only 10.5% progressed to more severe forms of RE. The patients with risk factors are candidates for aggressive therapy in order to prevent the progression of the RE disease process. Copyright 2002 Blackwell Publishing Asia Pty Ltd


30 Mar 04 - 06:27 PM (#1150472)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

recap: that was
mild reflux WITHOUT MEDICAL TREATMENT resulted in:

patients followed 2 years to 8.8 years, average 5.5 years
11% got worse
60% had relapses now and then or stayed the same
29% got better with no further episodes


31 Mar 04 - 03:13 AM (#1150730)
Subject: RE: Voice - stomach acids may have low odor
From: Steve Parkes

Re. the inclined bed -- if you have varicose veins, you need to tip the bed the other way, to help your legs drain better while you sleep.


16 Apr 04 - 02:44 PM (#1163379)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

Just saw this .

One thing it suggests is that, unlike GERD, exposure of the larynx to stomach acid/pepsin just a couple of times per week is probably enough to eventually cause chronic LPR.

In dogs as few as six applications of acid and pepsin to the larynx over a period of two weeks could produce frank ulceration of the cricoid. (And I guess that means that dogs regurgitating food for their young always get LPR?)

Ah well, it's a real prod to help one lose weight.


16 Apr 04 - 03:09 PM (#1163394)
Subject: RE: Voice - stomach acids may have low odor
From: steve in ottawa

Hey, back a bit I said:

The inclined-bed thing only has to do with stomach acids. I don't think it would affect most people's breathing.

but I was wrong.

Here's an article that links acid reflux to SIDS:
http://www.thevoicecenter.org/puppy_laryngospasm_manuscript.html


09 Jan 08 - 09:02 AM (#2231976)
Subject: RE: Voice
From: GUEST,neil

hi my name is neil i sing in a rock band and i'm having problems with my
throat and stomach i suffer from that well known germ living in my stomach it seems to run in the family . i also suffer from sleep apnea and over waight (18 stone)i'm having problems breathing and when i breath in heavy get a feelling that something is in my throat.latley when going out singing i seem to fail on the high notes. since my late wife have passed away from cancer i have a 11yr old son and i constantly worry about him losing me. please can you help im so worried about my shortness of breath all the time i been to see a throat specialist and he gave me an inhaler.


09 Jan 08 - 12:11 PM (#2232126)
Subject: RE: Voice - stomach acids may have low odor
From: maeve

Guest, Neil- Here at Mudcat (a music site) we can and do offer all sorts of advice and opinions, but you need to see good doctors for the real deal in terms of treatment. It sounds like you know you need help with both the sleep apnea and weight loss as well as the breathing difficulty- many of us can sympathize or tell what has helped us individually, but your concern for your son is well-founded, and we are not equipped to give the help you most need.

Please do push your doctor for the medical help you require, and feel free to stop in again for encouragement or to talk about folk and blues music.

All the best,

maeve


09 Jan 08 - 07:06 PM (#2232556)
Subject: RE: Voice - stomach acids may have low odor
From: stallion

The weight thing Neil suggest your neck size is greater than a 17 1/2 collar and the prof tells me that anyone with a collar over that size will have problems with the throat collapsing causing snoring and sleep apnia, I have problems with reflux and to be truthful I am struggling, I take 10mg's of Omeprazole and prop my bed up but when I sing it feels like something is stuck in my throat, oddly enough it is the lower end that seems to suffer. I had a camera down my throat and there is a thickening of a membrane that connects the two bits of the larynx apparently classic reflux damage although I have never had any pain, well that is until I had a heart attack which I thought for months was reflux!   The prof had a "Vocal Zone" whilst at Sinsul's which he said tasted like shit but worked, he has now been given some by an opera singing friend and is going to let me have one next week, I will report back on it's effectiveness!

Pete


25 Oct 10 - 05:23 PM (#3015290)
Subject: RE: Voice - stomach acids may have low odor
From: GUEST,Retta in Georgia

my problem is that until I was 49 or 52,53 I was a Lyric soprano, now I'm a good and blowing Tenor. I live in an area in Ga. where the pollen count can stay very high in fact they give us the pollen count in the wheather report, ya know; bu I teach Pre-k and some times I have to be careful not to raise my voice at them and when I do I get this rough feeling in my throat. Now I'm 67 and I am the musician for my church(28 yrs) and I can't show the sopranos how a certain part in the song should go; Very frustrating; I have two other ladies I sing with and I'm the tenor, and they call us the Clark Sisters of Hinesville (a famous Gospel group in Black Gospel) But at least I can sing, the Lord allowed me to keep the voice period, so I should be Greatful!! And I am really greatful!


26 Oct 10 - 04:34 AM (#3015551)
Subject: RE: Voice - stomach acids may have low odor
From: stallion

I didn't report back did I, well we are all popping vocal zones, although i still have a voice there is now a discernable rattle And I doubt if I could do a full weekend without squaking towards the end, I am pushing sixty now so I don't expect it'll improve.
Peter


26 Oct 10 - 09:35 AM (#3015748)
Subject: RE: Voice - stomach acids may have low odor
From: C-flat

"The proton pump inhibitor stops you making stomach acid rather than neutralising it. It seems to work but it isn't a permanent solution."

Certainly seems like permanent solution for me!
12 years and counting......
Treating the symptoms of my hiatus hernia to good effect with Raberprozole, best thing the doc ever did for me!
C-flat