Throat

Vocal hygiene refers to the healthy habits and behaviours that help keep your voice working well. Just like you care for your teeth or skin, your voice also needs proper care—especially if you use it a lot at work, socially, or recreationally.

Good vocal hygiene helps to:

• Prevent voice problems
• Reduce strain and fatigue
• Support recovery from vocal injury or therapy

Your voice is produced by the vibration of your vocal cords (or folds) in your larynx (voice box). Overuse, misuse, or poor care can lead to issues such as:

• Hoarseness
• Vocal fatigue
• Loss of voice
• Nodules, polyps, or laryngitis

Do’s

• Stay well hydrated: Aim for 6–8 glasses of water per day. Warm, non-caffeinated drinks are soothing.
• Rest your voice: Take vocal breaks, especially if you use your voice a lot during the day.
• Use a natural pitch and volume: Avoid shouting or whispering. Both can strain your vocal cords.
• Warm up your voice: Especially before singing, public speaking, or prolonged talking.
• Breathe from your diaphragm: Good breath support reduces tension on your voice.
• Practice good posture: Upright posture supports efficient breathing and voice production.
• Use amplification when needed: Use a microphone or voice amplifier if speaking to large groups.

Don’ts

• Avoid throat clearing: This can irritate your vocal cords. Try swallowing or sipping water instead.
• Don’t smoke or vape: These dry out and damage your vocal folds.
• Limit caffeine and alcohol: These can dehydrate the vocal folds.
• Avoid talking over noise: This leads to vocal strain.
• Don’t whisper when hoarse: It causes more tension than gentle speech.

• Humidity matters: Use a humidifier in dry environments. Ideal humidity is around 40–60%.
• Avoid irritants: Stay away from dust, chemicals, and allergens.
• Manage reflux: Acid reflux can irritate your larynx. Avoid spicy foods, eat smaller meals, and don’t eat right before bed.
• Address allergies and sinus issues: Postnasal drip can irritate the vocal cords.

Seek help from a healthcare professional such as:

• GP (General Practitioner): For referral and initial evaluation
• ENT Specialist (Ear, Nose & Throat): For examination of the vocal cords
• SLT (Speech and Language Therapist): For voice therapy and personalized advice

You should seek medical advice if you experience:

• Persistent hoarseness (longer than 2–3 weeks)
• Pain when speaking
• Loss of voice without a clear cause
• Sensation of a lump in the throat

If you are a teacher, singer, actor, coach, or use your voice professionally:

• Schedule vocal rest breaks during the day.
• Learn proper vocal techniques from a voice coach or therapist.
• Avoid speaking in noisy environments.
• Keep hydrated and well-rested.

Taking care of your voice is essential for communication and overall well-being. With consistent vocal hygiene, most common voice problems can be prevented or significantly improved

Globus sensation is the feeling of a persistent or intermittent lump, tightness, or something stuck in the throat, when there is no actual blockage. It is a common and usually harmless condition.

People often describe it as:

• A "tight" or "constricted" feeling in the throat
• A sensation of mucus or a pill stuck
• A non-painful lump that does not interfere with eating or drinking

Although it can feel alarming, globus sensation is not usually a sign of a serious medical problem.

• Sensation of a lump in the throat, especially when swallowing saliva
• Throat tightness that may come and go
• Feeling the need to swallow repeatedly or clear the throat
• Symptoms that improve when eating or drinking
• No pain or difficulty swallowing solid food

The exact cause is not always clear, but it is often linked to several contributing factors:

1. Muscle Tension or Throat Irritation

• Overuse of throat muscles (e.g. excessive throat clearing, coughing)
• Stress or anxiety causing muscle tightness in the neck and throat
• Voice overuse or strain

2. Laryngopharyngeal Reflux (LPR)

• Stomach acid rising up to the throat, causing inflammation and irritation

3. Postnasal Drip

• Mucus from the nose or sinuses dripping into the throat can create a ‘stuck’ feeling

4. Psychological Factors

• Stress, anxiety, and emotional tension can worsen the sensation

5. Other Factors

• Thyroid enlargement or neck muscle issues (rare)
• Previous throat surgery or trauma

A diagnosis is usually made based on your symptoms and medical history. Your healthcare provider may:

• Examine your throat and neck
• Use a flexible camera (nasendoscopy) to check your throat and voice box
• Rule out other causes, such as reflux or infections

In most cases, no serious cause is found, and reassurance is a key part of treatment.

Lifestyle and Self-Care

• Stay hydrated: Drink plenty of water
• Avoid excessive throat clearing: This can worsen the sensation
• Reduce caffeine and alcohol: These can irritate the throat
• Practice relaxed throat breathing: Helps reduce muscle tension
• Eat regularly: Eating often improves the sensation

Vocal Hygiene Tips

• Avoid shouting or whispering
• Warm up your voice if using it professionally
• Take voice breaks throughout the day

Stress and Anxiety Management

• Techniques such as deep breathing, mindfulness, or relaxation exercises can help
• In some cases, psychological support or therapy may be beneficial

Medical Treatment

If reflux is suspected, your doctor may recommend:

• Proton pump inhibitors (PPIs) to reduce stomach acid
• Antacids or alginate medications
• Dietary adjustments to manage reflux symptoms

Although globus sensation is usually harmless, seek medical attention if you experience:

• Pain when swallowing
• Difficulty swallowing food or liquids
• Persistent hoarseness
• Unexplained weight loss
• Coughing up blood

These symptoms may indicate another underlying condition that needs further investigation. 

Globus sensation is a common and usually benign condition. It may feel uncomfortable but is rarely a sign of anything serious. With simple lifestyle changes, reassurance, and management of contributing factors such as reflux or stress, symptoms often improve over time.

Laryngopharyngeal reflux (LPR) can be managed with the right treatment. By making lifestyle changes, following a healthy diet, and using prescribed medications, you can improve your symptoms and protect your throat.

Laryngopharyngeal Reflux (LPR) is a condition where stomach acid or contents flow back up into the throat (larynx and pharynx). This is also known as "silent reflux" because it doesn't always cause the typical heartburn symptoms associated with acid reflux. Instead, LPR often leads to irritation in the throat, hoarseness, and a sensation of something stuck in your throat.

LPR happens when the lower esophageal sphincter (LES), the valve between your stomach and esophagus, becomes weakened or relaxes inappropriately, allowing stomach acid to move upward. This acid can irritate the throat, voice box (larynx), and even the back of the nose.

Common causes and triggers include:

• Weak LES: The muscle at the top of your stomach isn’t functioning properly.
• Hiatal Hernia: Part of the stomach moves up into the chest, which may contribute to reflux.
• Overeating: Eating large meals or lying down immediately after eating can increase acid reflux.
• Obesity: Excess weight can put pressure on your stomach, promoting acid reflux.
• Pregnancy: Hormonal changes and pressure from the growing uterus can increase reflux.
• Smoking: Smoking can weaken the LES and increase acid production.
• Certain Foods and Drinks: Spicy foods, citrus, chocolate, caffeine, alcohol, and fatty foods can trigger reflux.

LPR can cause a variety of symptoms, including:

• Hoarseness or a raspy voice
• Chronic cough
• Sensation of something stuck in your throat (globus sensation)
• Frequent throat clearing
• Sore throat or irritation
• Post-nasal drip (mucus dripping down the back of your throat)
• Bad breath
• Difficulty swallowing (dysphagia)
• Lump in the throat feeling or tightness

Unlike typical acid reflux, LPR often does not cause heartburn, which is why it's often referred to as "silent reflux."

To diagnose LPR, your doctor will:

• Ask about your symptoms and medical history.
• Perform a physical exam and may look at your throat with a small camera (laryngoscopy).
• 24-hour pH monitoring: A small probe can be placed in your throat to measure acid levels over a 24-hour period.
• Barium swallow test: You may be asked to swallow a liquid that shows up on X-rays to examine how food and acid move through your oesophagus.

Treating LPR focuses on reducing acid reflux and protecting the throat from further damage. Treatment options include:

1. Lifestyle Changes

• Eat smaller, more frequent meals: Large meals can put pressure on your stomach, causing reflux.
• Avoid lying down after meals: Wait at least 3 hours before lying down.
• Elevate the head of your bed: Sleeping with your head raised helps prevent acid from flowing up into your throat.
• Maintain a healthy weight: Reducing excess weight can help reduce pressure on your stomach.
• Quit smoking: Smoking weakens the LES and can worsen reflux.

2. Dietary Changes

Certain foods and drinks can trigger or worsen reflux. It’s a good idea to avoid:

• Spicy or fatty foods
• Citrus fruits and juices
• Chocolate, caffeine, and alcohol
• Carbonated drinks
• Mint

3. Medications

Your doctor may prescribe medications to control stomach acid and protect your throat, such as:

• Proton Pump Inhibitors (PPIs): These drugs reduce stomach acid production.
• H2 Blockers: These medications also reduce stomach acid but work differently from PPIs.
• Antacids: Over-the-counter medications that neutralize stomach acid.
• Prokinetics: Medications that help your stomach empty more quickly, preventing reflux.

4. Speech Therapy

If LPR has caused hoarseness or a voice change, speech therapy may help. A speech therapist can teach you techniques to reduce strain on your vocal cords and improve your voice.

5. Surgery (In Severe Cases)

If medications and lifestyle changes don't help, surgery may be recommended in rare cases. Fundoplication is a procedure where the top of the stomach is wrapped around the lower oesophagus to prevent reflux.

If left untreated, LPR can cause:

• Chronic hoarseness or voice changes
• Throat ulcers or inflammation
• Breathing problems, like asthma or pneumonia, due to inhaled acid
• Damage to the oesophagus or voice box over time
• Increased risk of oesophageal cancer in rare cases, especially with untreated chronic reflux

While you may not be able to completely prevent LPR, these tips can help reduce the chances of it happening:

• Avoid trigger foods: Learn which foods worsen your reflux and avoid them.
• Don’t eat before bed: Give your stomach time to empty before you lie down.
• Maintain a healthy weight: This reduces pressure on your stomach and helps control reflux.
• Limit alcohol and caffeine: These can relax the LES and increase reflux.
• Stop smoking: Smoking can weaken the LES and irritate the throat.

You should see a doctor if:

• You experience hoarseness or a sore throat that doesn't go away.
• You have frequent throat clearing, coughing, or a sensation of something stuck in your throat.
• You have difficulty swallowing or a lump in your throat feeling.
• Your symptoms don’t improve with over-the-counter treatments.

What is LPR?

Acid reflux that affects the throat and voice box, causing hoarseness and irritation.

Causes

Weak lower esophageal sphincter, obesity, certain foods, smoking, acid reflux.

Symptoms

Hoarseness, chronic cough, sensation of a lump in the throat, sore throat.

Treatment

Lifestyle and diet changes, medications (e.g., PPIs), speech therapy, surgery (in severe cases).

Prevention

Avoid trigger foods, eat smaller meals, lose weight, avoid lying down after meals, quit smoking.

When to see a doctor

Persistent hoarseness, difficulty swallowing, or when symptoms don’t improve.ave frequent throat clearing, coughing, or a sensation of something stuck in your throat.

• You have difficulty swallowing or a lump in your throat feeling.
• Your symptoms don’t improve with over-the-counter treatments.

Laryngopharyngeal reflux (LPR) can be managed with the right treatment. By making lifestyle changes, following a healthy diet, and using prescribed medications, you can improve your symptoms and protect your throat.