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Vocal Cord Dysfunction vs. Asthma

Vocal cord dysfunction (VCD) is the abnormal narrowing of the vocal cords that causes asthma-like symptoms.


Symptoms include shortness of breath, hoarseness or wheezing, chronic throat clearing, chest or neck tightness, and trouble breathing. VCD most often occurs during high-intensity exercise, anxiety attacks, acid reflux, and exposure to varies irritants, such as fumes or strong odors.


Vocal cords are two folds of the mucous membrane in the larynx (voice box) at the top of the windpipe. They close and protect the airway when you cough and clear your throat in response to irritants, smoke, allergens, or illness.


In individuals with VCD, the vocal cords close involuntarily when they breathe, making it difficult to move air in and out of the lungs.


The attack is usually sudden and brief. There may be tightness in the throat, breathlessness, a feeling of trapped mucus in the back of the throat, and a voice taking on a raspy quality.


Once the irritant is eliminated, symptoms will typically improve promptly on their own. However, if the attack is severe, treatment may require the emergency room visit.


Since VCD is often confused with exercise-induced asthma, the differential diagnosis of the two is critical for proper treatment. Often people with VCD get misdiagnosed because the signs and triggers are so similar to asthma.


Some studies describe the average delay of 4 years in diagnosing such cases accurately. People with VCD can also have asthma and other laryngeal disorders at the same time, each of which will require an individual treatment plan.


The causes of VCD are not yet completely understood. Most commonly, VCD is linked to stress, anxiety, acid reflux, and uncontrolled contractions of the vocal folds.



Triggers


Top 3 triggers to cause the attack are vigorous exercise, post-nasal drip and gastroesophageal reflux disease (GERD). Conventional asthma medications don’t help patients with VCD. If a person has been misdiagnosed with asthma, an inhaler won’t help.


To avoid unnecessary treatments, spirometry (pulmonary function testing) is used to measure how much and how fast air moves in and out of your lungs. For the accurate diagnosis, spirometry needs to be performed while the patient is having symptoms.


If VCD is not active during testing, the result will show normal movements of the vocal cords; as a result, the test can't confirm or rule out a diagnosis.


The main treatment includes speech therapy with the emphasis on breathing techniques that will help a patient to control the vocal cords. Relaxation techniques and psychotherapy are also helpful in managing anxiety and stress that trigger VCD.


If you have asthma, post-nasal drip or acid reflux (GERD) and VCD, talk to a specialist about how to keep symptoms under control and prevent attacks.

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