Singing with Acid Reflux | Silent Reflux | #DrDan 🎤

– There is an epidemic of sorts running rampant among singers. Symptoms include reduced range, raspy sound, discomfort when singing, a continuous lump in the throat as well as reduced vocal stamina. If you are experiencing
any of these symptoms, then it may well be that you
are suffering from reflux. (cheering) (upbeat music) Hello everybody, welcome
to Voice Essentials where everybody sings. My name is Dr. Dan and I’m a contemporary singing voice specialist, it’s my job to help you get the very best
out of your singing voice. Today we are going to discuss reflux and its adverse effects on the voice. Now before you click away thinking that this video doesn’t apply to you let me quickly state that many singers don’t realize they have reflux because the common indicators of heartburn and indigestion don’t necessarily apply. It’s the absence of these two symptoms, heartburn and indigestion,
that lead us to refer to the type of reflux
we’ll be discussing today, as silent reflux or singer’s reflux. Because it’s often the singers who notice the effect of silent reflux first. So, what is it? Well, reflux simply understood, is the reverse flow of stomach
acids up the esophagus. Of course, stomach acid should, under normal circumstances,
stay in the stomach. But in some people, and I’m one of them, the back flow causes an agitation and burning of the esophageal
lining and vocal tract. Very quickly, by way of warning, I’m about to show you the inside of a larynx suffering from reflux. If you feel queasy
looking at body parts then you might like to look away. And special thanks to
Dr. Matthew Broadhurst for allowing me to use this footage. Now generally speaking,
the internals of the larynx what we’re looking at here,
have a light pinky hue. Here you can see that the rear of the larynx has a deeper red color. In particular, you’ll
notice that the arytenoids, those two lumps at the top of your screen, the rear of the larynx,
are a little swollen. In fact, in this video, we
can see that the surrounding musculature is also more red than usual. All told, this video is classic reflux, requiring a two-pronged,
therapeutic response. But before we talk about treatment, let’s first discuss what causes the reflux and how it affects the voice. (applause) There are several things
that can induce reflux. Common risk factors
include being overweight, heightened and sustained
stress levels and smoking. Certain food groups like citrus, tomato, chocolate and spicy foods
also contribute to reflux. Beverages such as coffee and alcohol and carbonated drinks all add to the risk. I know what you’re
thinking, the list contains many of the good things in
life, it’s a bummer hey. But left unattended,
reflux can have a seriously negative impact on your voice. A voice affected by reflux will often sound and feel raspy, some people complain of a constant lump in the throat which can make it uncomfortable
to sing, talk and swallow. And I know when I’ve let my
reflux get out of control because my range, vocal
agility and stamina are all compromised big time. And more importantly, chronic reflux, when not treated and managed can lead to cancer of the esophagus, a condition that has an
extremely low survival rate. Ultimately there’s more at
stake here than your singing. If you suspect you’re
suffering from reflux then I advise you to
visit your family doctor who will be best placed
to direct your care. As a prelude to your medical consult, let’s preview what their
response may include. (applause) Okay, so how do we treat
and manage singer’s reflux? Great question, the answer is two-fold. Lifestyle and medicinal,
and in that order. Best practice always
addresses lifestyle first. So lifestyle changes
such as losing weight, quitting the smokes and
learning to manage your stress all lead to healthy outcomes. Personally, my big three are spicy foods, I love hot Thai curries,
double shot flat white coffees, and scotch whiskey. If I feel my reflux starting to flare up I immediately assess my lifestyle habits in these three areas. Your stimulants could be different, for example, they might include citrus, tomato-based foods or even garlic. Moderate your diet and your reflux will often improve significantly. You should also avoid eating or snacking three hours before you go to bed to allow your food to digest and move beyond the stomach into
the small intestine. You might also like to
try raising your bed head up onto three house-bricks when you sleep. Having your head raised
up above your belly when you sleep helps your stomach acids to remain in the stomach. It feels weird to sleep on a slant for the first few nights, but after about a week or so you get used to it. And if you’re like me then
despite your best attempts to manage your reflux
through lifestyle change, you might require some
medical intervention. Now in my personal case, our family doctor has prescribed a daily
40 mg dose of Nexium delivered as a once a day tablet. And for most folks, 20-40
mg daily will suffice. Now if you’re reflux is
really out of control, however, your doctor may prescribe a double dosage for a short period of time just to get it back into
a safe and managed zone. The drug Nexium is a proton pump inhibitor that reduces the amount of
acid your stomach produces. There are other drugs, other
proton pump inhibitors, include Prevacid and Protonix, your doctor may also prescribe an
over the counter antacid such as Mylanta or Gavascon,
for those moments when the reflux really flares up, especially straight after meals. As always, your family
doctor is best placed to diagnose and prescribe
a medical response, so make sure you book an appointment if you suspect reflux is impacting on the quality of your singing voice. I wonder whether you
suffer from reflux like me, how do you manage it and
its effect on your singing? Leave a comment below so that we can all learn from your experience. If this is your first time watching one of my videos, good day! Allow me to invite you over to my channel for many more videos just like this one. My channel has been designed to develop your voice and improve your sound. I hope you’ll take the time to subscribe and join our ever-growing community of singers from across the globe. I’ll see you again soon. I’m Dr. Dan, sing well.

62 Replies to “Singing with Acid Reflux | Silent Reflux | #DrDan 🎤

  1. Same three for me! Curries, Diesel coffee(The whole house reeks by my morning cuppa's!) and Guinness! Luckily I drink a ton of water however. How many cups of coffee a day is adequate would you say Dan?(please say two, please say two!)

  2. Thank you so much for making this awesome video Dr.Dan! I really appreciate this😊❤I was diagnosed with gastritis and Brett's esophagus and so my singing has been really affected so much so that my throats hurts after a few minutes of singing. My doctor said to take nexium , and I was also prescribed Pantoprazole. I wasn't however made aware of the foods I was to avoid so thank you! I will try that out and update you! Again, thank you so much😊❤

  3. I suffered from reflux for quite long time. It was one of the worst experiences in my life. Sleeping on a high pillow has helped, and managing my stress has been crucial. Thanks, Dan.

  4. I was recently diagnosed with it and I am quite worried because in three months medications did not help. I feel like it is just getting worse. I really cannot cut off all that forbidden foods, I drink only one macchiato per day now for example but cannot cut off everything. How can I know what triggers it?

  5. I suffer from silent reflux that resulted in some major vocal issues (even had a 24 hour pH level probe to confirm). My ENT prescribed 300mg of Zantac and a change of diet. I find I still struggle with reflux, and the daily vocal symptoms. I'm hoping with continued lifestyle changes I can wing off my prescription.
    What do you recommend for those suffering (and working to fix the problem), but still have to sing for gigs? Any tips to help bring relief to sore and acid ravaged cords?

  6. I have silent reflux; only drink water, stay away from all foods in the list, sleep with a 'reflux approved' bed wedge.. yet when I first started taking 30mg lanzoprazole it was getting better… it's now getting slowly worse and I have a sore throat/ lump/ raps/ loss of range all day every day! These videos give me hope that it can be treated and fixed. Going back to the doctor next week to see what he suggests. I can't even imagine a life without reflux! I would be so happy xxxx thanks for these great videos xx

  7. Hey Dan I have a problem with singing. Before I warm up, I can't sing above A3 and my voice sounds raspy and cracks a lot. Recently people have found out that I sing and have randomly ask me to sing but when I do, if I'm not warmed up, I can't sing good at all. However, when I warm up (do lip rolls and scales for 5mins) I can sing up to an E4 easy. How do I make it that I can sing good without warnin' up? Because there are ALOT of people I know who can sing amazing when someone randomly says to them "can I hear you sing?" Even if they aren't warmed up, they still sing on pitch and with a nice tone. But with me, I can't sing without warnin' up at all, I sound like an absolute beginner. Why is this?

  8. Dr Dan, I've been fighting silent acid reflux for years. My Daughter is a ENT PA and said I could have a mix with post nasal drip. I tried Prilosec to no avail. I have a gastric band and am wondering if it could be contributing to the congestion.
    Rick Shaw

  9. Dan, I've been playing around with Bragg's apple cider vinegar. Not sure yet. I got off the PPIs when I read about their long term effects on your bones.

  10. My range has been shot lately and my stamina onstage continually dwindling with each show, but I never thought about reflux as a potential issue until a fellow singer suggested it and, with curiously fantastic timing, you uploaded this video! I do drink a LOT of coffee and eat spicy foods on an almost daily basis, so I think this is a wake up call to change my diet, drink more water and cut back on all the stuff that's detrimental to my voice. I was genuinely scared that I'd lost my higher range completely but I think my cords were inflamed from oversinging as, after almost two weeks of rest, I can access my head voice again. In the long-term though, I can see that reflux may well be an unnoticed problem for me 'cause I've experienced similar issues in the past but thought it was just down to bad technique or vocal abuse (since I used to do a lot of experimental extended technique and screaming stuff…badly).

    Thank you for another quality video, Doc!

  11. I am a voice teacher of over 30 years. I lost my voice for 3 or 4 years, due to an "unknown cause", which one of the many doctors that I consulted finally labeled as reflux (he told me that many people suffer from reflux but don't know it, because it only occurs at night – when they're asleep). He wanted me to take Zantax and some nasal spray that I can't remember the name of; but I am very adverse to drugs of any kind, so I began sleeping propped up on on three pillows at night, drinking a large glass of water upon awakening in the morning (yes, even before coffee), and restricting myself to only three cups of coffee before 10:00 AM; eating out at restaurants only once or twice a week (all the rest of my meals, I make myself, from scratch), and doing thorough stretches every morning, as soon as I arise. It has been about 2 years, and my voice is slowly returning, in spite of my advanced age. Patience and perseverance seem to be the key.

  12. Once again, you deliver valuable information Dan! I've been unaware of this problem and noticed only that the abdominal pressure caused my breath to, well, become unpleasant while singing. Luckily, Gaviscon foam, even though I need to gurgle a lot, is quite good, if used profylacticly.
    I enjoy your vids greatly! Marci Pan (Marcin)

  13. hi dr dan, do you think that my inability to sing falsetto majority of the time could be due to reflux? When i try to sing falsetto, it feels stuck at times.

  14. I have seen several ENTs and after scoping me they all say the vocal folds are irritated due to reflux. I was put on a PPI which brought my voice back for 2 years. It has now happened again even though i lead a very healthy life style. I doubled my dosage with no luck. Then went to see a Gastro. He put me on Dexilant which led to kidney/lower back pain. So idk what else to do. I quit coffee, alcohol, sleep elevated, never eat problem foods, dont eat before bed, go on vocal rest for days and still I wake up every morning like I was screaming at a concert all night. I head there can be major complications with surgery. But with all that I am doing how can I be sure its reflux?

  15. Thank for the video –

    Question. Most reflux is a result of low acid in the stomach. If you are taking a proton pump inhibitor that limits the amount of acid, then how is that helping? Can you explain more about that.

  16. I was so tired of all the reflux symptoms that kept increasing, I decided to go to my family doctor. He gave me Omeprazole 20mg to try for two weeks. He is a bit reluctant to prescribe it for longer because of my young age (23). Although it gives me a range of symptoms, I'm specifically a bit worried about my voice. My vocal stamina is much reduced and, already for quite a while, my voice doesn't really sound clear; it's a bit raspy.. If the reflux becomes manageable, will my voice recover in such a way that it will sound clear again? Or can my vocal cords really be permanently damaged? Thanks! 🙂

  17. Thank you for this very useful information I am just beginning to experienced reflux, I am a member of a choir in our first I thought it was just an ordinary cough..until it keeps on recurring especially at night..these info are very helpful to us who have been suffering from this kind of condition..maybe early detection and medication plus natural remedies can help a lot..just a matter of disciplining ourselves in terms of our lifestyle and food intake will eleminate reflux..

  18. Hii dr dan …I have a same problem but I came to know about after 1 yr nd found tht my food pipe is little bit of loose nd give a same advice as u r saying ..nd I'm doing same I ws singer bt since last 1 yr in my voice the is a hoarseness nd does not hv strength nd clr … should I take a throat medicine with reflux cure medicine tht is NEXPRO Rd 20 or should wait till it's completed???? Pls response me dr I'm very stress nowadays

  19. Milk was the easiest thing for me to quit drinking I don’t really eat oranges and try to drink mainly water and my Throat coat my vocals do get tired not as quick as they used to but still fairly quickly I like to eat apples and bananas I’m not in bad shape I was a runner in high school i graduated last year but in 2017 if that makes sense ha I don’t like candy i know what it does so I want even less of it I do like pancakes though ohhh and French toast i was going to finish that and the eggs and sausage I got from McDonald’s but it’s not good then I won’t ha and I didn’t know about trying to eat 3 hours before sleep I know you’re supposed to sip on water 😅 but sometimes I just get thirsty but I know there’s times when I can’t sing at all so I just stay quiet it does get frustrating not knowing what to do I feel like I’m really messing up my voice there’s a lot to learn but I can tell when my voice is compromised umm do you know how much an ENT cost I think it’s called ha and if any of the stuff I listed above is ok to eat oh and syrup I want to know about that too 😅 it’d be easier if I could get a list of this do you know a website for it 🤔 thank you

  20. Thanks for your video. I suffered bad reflux for years. Doctors could do little. I never recommend drugs. Cured it with herbs and other natural aids to rebalance my digestive tract. Too much sugar is a main cause. Candida overgrowth tied to sugar is another. Drinking raw apple cider vinegar in water with a dash of honey everyday helps a ton. 1 tsp baking soda with 4-6 oz water for immediate relief, especially 30-40 mins before bedtime. Or, a small squeeze on non fluoridated toothpaste is great too. I recommend Desert Essence brand.

  21. I started to have symptoms of Laryngitis after a little voice stress. The symptoms got worse and worse and my larynx got infected, so I stopped singing. Not only that, I got symptoms of and misdiagnosed as post viral fatigue. Eventually, I went to see a throat specialist who diagnosed reflux. Within 48 hours of starting a dose of Omeprazole, my energy levels started to return. But I was not given any proper information on how to mitigate the symptoms until now. So I've lost out on 7 months of singing, song writing because of this misdiagnoses. I have just started to do gentle singing exercises.

  22. Thanks for the helpful videos! I've been watching several of your vids as I've been searching like a fiend for a few weeks looking for answers. Annnnnd….. I think I may have found what is happening to me? The last five gigs (three one hour sets) I've had little to no stamina, lost my voice by the last set and the following day I'm sore/raspy. THIS IS NOT LIKE ME. Apart from research, I've been doing voice rest, gentle warm ups, steaming, resting as much as possible, massage, drinking heaps of water and yet songs that are usually easy are a full on CHORE and control is out the window. It feels sort of like trying to sing while holding back massive tears! By the end of the gig I am KNACKERED. (Again, not like me at all) I have the up-nose down throat scope ENT booked for next month (my 1st time here's hoping all goes well)… until then I will avoid ALL the triggers just in case. I love coffee and curry but I love singing much more!!! Crossing fingers I've found a solution as I am this close to cancelling gigs. How long does it usually take for a voice to come back around after suffering this for a few weeks?? Oh, and full disclosure….. I am ashamed to say I had been smoking cigs on and off for the past 4 years or so. 🙁 I quit cold turkey about 3 weeks before all this started so I thought maybe there was a connection as I shake all that nastiness outta me.

  23. I took acid reflux reducers for a couple months, and I’m doing better. I had to quit because my mom read online that it can cause me to get liver cancer. But my acid reflux is doing better. I’m also a singer so it was very difficult nearly impossible for me to sing perfectly because the acid would come up into my throat while I was singing. But now I feel like it’s doing better. I would also constantly have to clear my throat throughout the entire day just to be able to speak clearly because it would also happen while I’m having a conversation. But like I said I feel like I’m doing much better. The best part is that I can sing normally now, without having to clear my throat all the time and it’s amazing! But sometimes I still have to be very careful about it because since I’ve stoped the medications, it comes back once in a while. But it’s definitely not alas bad as it was before when I was younger.

  24. At the begining of my twenties I had the vocal range of Maurice White
    and Phillips Bailey from Earth, Wind and Fire. I could sing their parts with no problem, and I'm not lying. Then it came the f*****g acid reflux and my vocal chords
    burned out, sadly I never be able again to achieve the Bailey's register
    but a bit of White's. It's disgusting to try to sing someone's register
    and the sound it comes out of your throat it's like the noise of a
    radio out of tune.

  25. My advice is stay away from ppis period…
    They are poison, stopping stomach acid production is not the way forward. And ppis have made a lot of silent reflux suffers symptoms worse..start with your diet buy Jamie Kaufmans book the reflux diet and cook book…this really helps

  26. Sir, I wish to inquire, how long does the healing take in case of serious reflux cases using mere lifestyle change, yoga and diet. Complete loss of stamina, vibrato inefficiency and loss and voice hoarseness and globus/lump sensation are the symptoms. I was diagnosed at the best medical Institute in my country but even they couldnt diagnose it despite my clearly stating the symptoms. i found help on a website. The medical apparatus around isnt competent perhaps. im a tad bit distraught with this condition as i dont know much about it. Any advice with be highly appreciated Sir. Also, is it fully curable? will my voice recover completely and sound as before in terms of ease, comfort, vibrato and eradication of hoarseness? and finally, how much talking and singing is permissible in this phase? I hope to hear from you soon. Best regards.

  27. Hi Dr Dan I was diagnosed with silent reflux which has affected my falsetto. I've been taking omeprazole which reduces the acid but my falsetto is still not attainable. Please put me out of my misery, is this something I can get back?

  28. Hello sir! I went to the doctor a couple of months ago and I do have acid reflux and post-nasal drip. At first, the symptoms were alleviated by cutting out foods, medication, propping up head, everything in the book but this past week my throat has been sore but not the it-hurts-to-swallow kind but when I swallow I am aware of something. When I sing I don’t feel anything actively but afterwards it is bothersome sensation, kind of ticklish and hot. Hurt is a little far but I am wary of talking afterwards and I am very aware of my throat after singing. I have been known to be very tense when I sing and I have been singing more often lately because I was just cast as the lead in a musical, but I’ve been rehearsing like this for a month now. It feels like I get this feeling, rest my voice, all is well for a little bit and then I get the feeling again and it all starts over. I’m sort of freaking out because I’m worried I’ve damaged voice. My range used to go up to a G6 on a good day but now it only goes up to a D6 (if I warm up substantially). Is it because of my acid reflux or have I actually damaged my voice?

  29. Hi Dan! Thank you so much for this video. I was just recently diagnosed with this reflux. As a vocalist I noticed a lot of changes in my voice that were concerning. One of them is feeling like I have a lump in my throat when I sing. Is this something you have experienced? I’m considering seeing a vocal coach to see if maybe I am using incorrect muscles to compensate for the loss of vocal ability. Thanks for your hard work and I look forward to viewing more videos!

  30. Dr. Dan… Do you remember me..? l asked a question yesterday about obstruction feeling in throat.. is acid reflux the reason for that ?

  31. Please help.. me.. I dont know… What has happened ! Whenever i hit a note like A4 or g#4 my voice gets distort ..i get voice like vocal fry at high note. . and then voice continues in lower note if i sing normally . I can hit it easily noe and earlier but.. unable to get rid off that kind of..unwanted distortion!!

  32. Hello Dr Dan.
    So Im a vocalist and over the course of the last few years Ive been facing vocal problems. My current vocal condition is such that any note which I attempt to sing (Even in my comfortable middle octave range like a middle C ) is always 5-10 percent flat from the required pitch. Ive consulted a few different ENT doctors over the course of time. They all repeatedly diagnosed acid reflux. However there has been no improvement over the years. Besides the inability to match pitch, there is even fast vocal fatigue and and very jarring tone to my voice. Any idea what this condition could be? Havent been able to find any information anywhere so any feedback would be really appreciated . Thank you.

  33. my son loves singing in fact he has joined some singing competitions. but lately he can't manage to finish singing a song as he said he felt some gas coming from his stomach. At first we thought he is just nervous on one big competition he joined where in he also suddenly stopped at the middle of the song. Good thing he was able to continue but we observe now even during practices at home he will stop at the middle of the song and said that he felt some gas again coming from his stomach. He needs to burp while singing just to continue and you can see that his singing is really affected. There are also times when he felt some excessive sweating on his back and some coldness on his feet . Is this also a sign of silent reflux? He is now sad that he can't even finish 1 song and can't do perfectly what he really loves doing. Kindly please advise.

  34. Im overbese. Sang classical and taught singing and choirs. Ate wrong foods continuously. Lost voice last November. Quiet breathy phonation E4-C3 very frustrating. Not too mention being a class teacher daily talking and trying to sing. Now its nearly a year now so now I'm changing diet losing weight and seeing if changes a coming. Id love to get back into some lieder. Thanks for the info good motivation. Do you do vocal coaching?

  35. I use apple cider vinegar in a capsule form…it won't hurt your throat going down! That, along with stopping coffee, and elevating my mattress have helped dramatically. Raspberry tea and elderberry syrup help too!

  36. Thanks for this video Dr Dan, really helpful! I've recently been diagnosed with acid reflex and like you my doctor has put me go 40mg of Nexium. I'm pretty healthy and have cut out any of the dietary things needed in the past 10 days (since diagnosed) but my voice is still very compromised with all the things you described. I have a gig tomorrow night, I am wondering if you have any tips for getting through the gig?

  37. My voice is shaky while singing Is it because of reflex?? Dr.told me that my vocal chords are swollen. How can I sing ??

  38. Sir I am experiencing acid reflux. It affected my voice.My voice is not steady. It is shaky .How can I sing?? What should I do??

  39. I've had two or three bouts of persistent light coughing which was finally diagnosed as reflux that fried my vocal cords. I must have had a combo of things, as there was a hiatal hernia diagnosed later via endoscope. (I fixed it, by the way, using a manipulative technique found on Youtube). The silent reflux, though, continues. I will say, when I've gone on Nexium plus Zantac, it really stopped the coughing and throat irritation fast… couple of days. However, I also don't want to be drug dependent and I do worry about the long-term effects of PPIs, so I weaned myself from those and tried to compensate with even greater attention to the dietary stuff. That DOES work. I found it hard to avoid those favorite things though and have gradually gone back to all of them. So now the coughing is back a little too. What I really need to do is drop about 20 lbs. All that said, I have a question: Does singing actually make silent reflux worse? Or is it, as you said, just that singers are most likely to notice it first? I ask because something else I do is snore, and I've wondered if singing lessens would help strengthen my throat so the snoring will stop.

  40. My voice has been RUINED by reflux over the past two months. It's really been pissing me off. I used to have no trouble staying on key, but now I go flat all the time and have the reduced range. I've been dealing with reflux and stomach ulcers my whole life because of a genetic condition that causes my stomach to produce way more stomach acid than normal. I can be perfectly fine all day, and then suddenly my stomach will start fucking itself with acid, be unable to handle it, and force it all the way up into my throat. My voice was just fine today and then suddenly that happened for less than a second and it felt like I just swallowed burning gasoline. Now my voice is going to be ruined for the day. I take medication and regulate my diet, it's just stress. Being a college student, it's just impossible not to be stressed, and the heartburn makes the stress even worse. So tired of dealing with this, and the ulcers

  41. Great video! Q: If its 'silent reflux' what indicators are there to tell you to change lifestyle?
    -Also do you recommend seeing an ENT for this kind of problem?

  42. I’m 16 and when I was younger, I was diagnosed with Acid Reflux. I had taken medicine for a while and decided it was time to stop taking it. My stomach aches and heartburn stopped but now I constantly have an excess amount of mucus in my throat which affects my range and sound when I sing. I often spit up mucus and cough all the time but my parents don’t think it’s a problem. I refer to your videos a lot. For example, I adjust my diet. I haven’t had carbonated drinks in years. I try not to drink or eat dairy, and I swore off coffee a long time ago. But for some reason my throat is still being affected.

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