ZocdocAnswersIs alcohol the reason I have throat hoarseness when I wake up?

Question

Is alcohol the reason I have throat hoarseness when I wake up?

Is it because I am dehydrated? It takes a while for my throat to feel normal and I don't drink that much. Maybe a few shots. I'm a 32 year old man. Should I not drink?

Answer

This is a very good question. First of all I am sorry to hear that you have been suffering from hoarseness when you wake up in the morning. I am happy to give you some ideas as to what might be going on, however there is no way that I can tell you with certainty exactly what is going on without being able to take a more detailed history and a thorough physical exam. Hoarseness is a relatively common complaint and reason for visits to the ENT (ears, nose, throat doctor) office. One of the most common causes of hoarseness is reflux. There is something called laryngo-pharyngeal reflux disease (LPRD) which may be the etiology of your hoarseness. When you are awake and upright, gravity along with your esophageal sphincter (valve-like muscle at the top of your stomach) help to keep stomach acid from refluxing into your esophagus (swallowing tube). However, at night when you are lying flat gravity is no longer helping prevent reflux, and if the valve isn't functioning properly, stomach acid can pass into the esophagus and all the way up to the larynx where it irritates the back of the throat and can cause hoarseness. This causes mucosal changes in the larynx which can sometimes be seen by exam in the ENT's office. Furthermore alcohol causes relaxation of the esophageal sphincter, so if you drink at night before bed, you are at even higher risk of refluxing. This is my best guess without actually looking at you, and without being able to ask you more questions. I would definitely recommend seeing an ENT to get checked out. I hope this helps.

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