Acid reflux is a professional hazard for many singers but little is known of the cause.

As a singer who has trained intensively from time to time for national competitions I have noticed acid reflux develop; I have also undertaken a vocal ailments research project, part of which investigated how singers experience acid reflux.  In mild cases it is just uncomfortable but many singers find it can affect the surface of the vocal cords, causing hoarseness and loss of voice, particularly after periods of intense rehearsal or performing.

After some thought on why acid reflux occurs in singers, I have come to the idea that it is the mechanics of good singing support which can weaken the cardiac (lower oesophageal) sphincter  - the opening to the stomach from the oesophagus (gullet).

Good singing support involves tensing the muscles of the abdomen and the diaphragm to create a steady column of air from the lungs through the voice box, much as a hand squeezes an icing bag to create a steady stream of piped icing (frosting).  Some singing styles require lengthy passages to be sung in one breath, requiring these muscles to be held tighter and tighter as air is expelled from the lungs.

The stomach lies between the abdominal muscles and the diaphragm and the oesophagus passes through the diaphragm to the cardiac sphincter just below.  No-one likes to sing on a full stomach for the reason that the stomach is also squeezed during muscle supported singing.  Even if the stomach is relatively empty, muscle supported singing may create pressure on the cardiac sphincter which may become weaker over time.  A loose cardiac sphincter is more likely to leak stomach acid when lying down.

As tennis players can develop tennis elbow from repetitive use, singers' weak spot is the cardiac sphincter.  Conventional treatments aim to neutralize the stomach acid and advice is often given about not eating late at night and sleeping propped up in bed.  I also recommend monitoring the symptoms of acid reflux so that you know when your body is saying: 'enough singing!'.  I appreciate this is hard for professionals and their rehearsal/performance schedules, but do allow as much time for the body to recuperate.  I recommend having a full homeopathic consultation to support recovery.

Having researched homeopathic remedies which have an action on the voice, I recommend the remedy Chlorum (chlorine) for occasional voice loss from acid reflux which is available in my Homeopathic First Aid Kit for Singers and homeopathic pharmacies. It is also a useful remedy when the voice is impaired after drinking wine.