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Common causes of a hoarse voice In addition to upper respiratory infections and overuse, your hoarse voice could be a symptom of: Gastroesophageal reflux disease (GERD): when stomach acid travels up your esophagus and irritates your larynx Vocal polyps, nodules, or cysts: bumps on your vocal folds Vocal fold bleeding: ruptured blood vessels Vocal fold paralysis: dysfunction typically caused by injury or infection Neurological disorders: nerve miscommunication or neurological disease When you have a voice problem, the most obvious culprit seems to be the vocal cords and the soft tissue folds that generate sound

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