Hoarseness: a sign of self-induced vomiting?

Acid reflux, which is the entry of acidic gastric contents into the upper gastrointestinal tract, may manifest as two clinical syndromes-gastroesophageal reflux and/or laryngopharyngeal reflux. The latter syndrome, laryngopharyngeal reflux, is associated with the symptom of hoarseness. In the literature on eating disorders, according to general articles on medical complications, case reports, review articles on reflux, and empirical research, patients with self-induced vomiting (e.g., anorexia nervosa binge-eating purging type, bulimia nervosa purging type) are at risk for acid reflux, potentially culminating in either reflux syndrome. Because of the unique voice effects encountered with laryngopharyngeal reflux, hoarseness may be an indistinct clinical indicator of an eating-disorder syndrome characterized by self-induced vomiting-particularly when present in a young female of normal weight or underweight status. Thus, hoarseness in young women may suggest an eating disorder, both in psychiatric and primary care settings.