Difficulty Swallowing and Hoarse Voice

What are swallowing disorders?

Swallowing is something we do without even thinking. But if the throat becomes too dry or we have an illness that affects our ability to swallow, the act of swallowing can take great effort and may even become painful. While most swallowing problems are temporary and short-lived, some may be linked to something more serious such as a brain or nerve disorder. A condition called dysphagia is a swallowing disorder commonly associated with damage to nerves that affect swallowing.

Speech and swallowing problems may be caused by many different factors, events, physical illnesses and diseases. Swallowing can be affected by:

Issues with voice may be caused by:

  • Aspiration (inhaling something)
  • Chronic cough
  • Chronic hoarseness
  • GERD
  • Vocal cord cysts or polyps

The voice and the ability to swallow may also be affected by dental irregularities, such as malocclusion, or even by ill-fitting dentures. In rare instances, a tumor in the mouth, throat or esophagus causes swallowing or voice problems. 

GERD is the recurring movement of stomach acid from the stomach back up into the esophagus that can cause heartburn or chest pain. Acid reflux into the larynx occurs when acid travels the length of the esophagus and spills over into the larynx.

The esophagus can withstand a certain amount of acid exposure, but the throat and larynx (voice box) are not meant to withstand any exposure to acid. Any acidic irritation to the larynx may result in a hoarse voice. As the vocal folds begin to swell from acidic irritation, their normal vibration is disrupted. Even small amounts of exposure to acid may be related to significant laryngeal damage. If acid actually refluxes into the lungs, chronic cough and pulmonary conditions can result, such as pneumonia or bronchitis.

Symptoms of voice or swallowing issues

Common symptoms of swallowing issues include having the feeling of a lump in the throat or having a hoarse voice. You might also feel a pain in the throat or chest, and in some cases, may experience drooling.

Symptoms of acid reflux into the larynx may include:

  • Laryngitis (loss of voice) or hoarseness
  • Sensation of a lump in the throat
  • Post-nasal drip
  • Chronic throat clearing
  • Excessive throat mucous

You may also experience sore throat, cough, laryngospasm (spasm of the throat), and/ or throat pain. Acid reflux can also have an impact on swallowing, speaking and singing.


Treatment for swallowing and voice issues generally involves a combination of medication, such as to reduce acid reflux, and lifestyle changes. In some cases, additional therapy such as speech therapy may be needed. Surgery may be recommended if nonsurgical approaches have failed to improve your condition.

Esophageal Dilation

Esophageal dilation is a procedure that addresses stricture, or narrowing, of the esophagus, the swallowing tube that carries food from the mouth to the stomach.

Esophageal Motility Study (EMS) or Esophageal Manometry

Esophageal manometry is a useful test in evaluating gastroesophageal reflux or a suspected motility (swallowing) disorder.


ENT (Otolaryngology) and Audiology

Main Line Health otolaryngology and audiology experts treat and manage conditions affecting your ears, nose and throat at locations in the Philadelphia area.


Main Line Health gastroenterology works to resolve digestive issues and GI conditions. Find the right solution for your digestive conditions at one of our Philadelphia locations.