The Roles of Silent Reflux in the Treatment of Professional Voice User: Myth or Reality?

Schlomicher-Thier J, Weikert M. The Voice Foundation. 2013 June.


OBJECTIVES: The Authors will speak about individual changes of lifestyle and bad dietary habits and the rule of Restech pH-Metrie and dietary advices in professional and nonprofessional voice users.

Patient with symptoms of LPR typically do not exhibit classic symptoms of gastroesophageal reflux disease (GERD). Therefore, it is sometimes difficult to provide counseling regarding reflux guidelines for the patient. Professional singers perform singing tasks that require rapid changes of subglottal pressure and consistent use of the diaphragm, with activating the diaphragm when there is a need for a rapid decrease in subglottal pressure, which causes an abrupt and prolonged increase in intra-abdominal pressure, deep inspiration and straining. These mechanisms, repeated several times per day and over many years of professional activity, could, in theory, increase the occurrence of reflux symptoms by disabling the diaphragmatic sphincter. Therefore the silent reflux is one of the most important factors in the pathophysiologie of voice disorders in professional singers and voice users. Treatment options for LPR may include medical and behavioural management and surgical treatment in special cases. Proton pump inhibitors (PPI)plays a great role in the therapy of LPR but should be taken in an optimal manner and the counseling to optimize dietary and lifestyle modification should be started immediately. There are many lifestyle problems at the vocal Artists, like: inadequate sleep, increased body weight in adulthood, dinner just before bedtime , the habit of midnight snack, lack of breakfast, lack of physical exercise, anti-hyperglycemic agents non-users, the habit of quick eating, lack of breakfast and dinner just before bedtime.

 

Topics: pH monitoring, ENT, voice, Diet & Lifestyle, 2013

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