Reflux Symptom Index


Studies have shown that many people with vocal disorders have laryngopharyngeal reflux (LPR). LPR occurs when stomach acid travels up the esophagus and into the voice box or throat, during the day or night.

Patients can get relief through lifestyle changes.

The following Reflux Symptom Index (RSI) (Koufman, Belafsky, Postma, et.al 2002) uses nine items to help you rate the severity of your condition specific to LPR.

A score of 10 or more on the following quiz is considered clinically significant.

Within the last month, how did the following problems affect you?

0 = No Problem 5 = Significant Problem

0 1 2 3 4 5
Hoarseness or a problem with your voice
Clearing your throat
Excess throat mucus or postnasal drip
Difficulty swallowing food, liquids or pills
Coughing after you eat or lie down
Breathing difficulties or choking episodes
Troublesome or annoying cough
Sensations of something sticking in your throat or a lump in your throat
Heartburn, chest pain, indigestion or stomach acid coming up
Total:

The first line of defense is behavioral:

Diet Dos

  • Eat slowly
  • Eat sitting up
  • Eat smaller meals
  • Avoid overeating
  • Chew food thoroughly
  • No food 2-3 hours before bedtime
  • Restrict liquid/food intake before singing and/or lifting, bending or stooping

Diet Don’ts

  • Alcohol
  • Soda
  • Citrus juice
  • Tea/coffee
  • Breath fresheners
  • Mints
  • Milk
  • Chocolate
  • Spicy and/or fried foods
  • Lozenges and cough drops
  • Tomato products
  • Tobacco

For one week, write down what you eat and drink through the day along with symptoms in the morning, afternoon and evening. This will help identify what affects your gastric reflux more.

Posture & Weight Dos

  • Achieve and/or maintain your ideal weight
  • Expand your abdomen when breathing in

Posture & Weight Don’ts

  • Exercise right after eating
  • Tight clothing around your waist
  • Slumping down in a chair
  • Heaving lifting
  • Kneeling
  • Bending at the waist

Other Lifestyle Modifications

  • Stop smoking
  • Reduce stress and tension
  • Avoid sedatives
  • Sleep with the head of your bed elevated 4-6 inches via cinder blocks, wood or bricks under the legs of your bed
  • Sleep on your side, preferably your left side

Remember, acid reflux at the level of the larynx (LPR) is often “silent”. Positive or negative results from this quiz do not necessarily correlate with positive or negative results upon examination.

You can reach Performance Voice Solutions, a division of Northside ENT, at (317) 705-2732.