Acid reflux (GERD) often causes burning in the chest when stomach acid enters the esophagus. However, those symptoms are absent when someone experiences silent reflux,also known as laryngopharyngeal reflux (LPR).

With silent reflux, stomach contents travel upwards in the esophagus to the area of the voice box (larynx). This does not always lead to the traditional symptoms of GERD, such as indigestion and chest pain, but can cause significant symptoms despite the “silent” part of its name.

“Most people hear ‘acid reflux,’ and they think of the searing pain of heartburn,” general surgeon Annie Laurie Benzie, M.D. says. “Silent reflux instead causes throat-related symptoms, including coughing, hoarseness, loss of voice and sore throat.”

Symptoms of Silent Reflux

It may surprise you to learn that reflux may be the cause of throat discomfort without feeling heartburn. If your throat hurts, you may presume that it is a cold, not reflux. Your physician will be able to help in diagnosing the correct condition.

If you have silent reflux, you may experience symptoms such as:

• Chronic hoarseness
• Changes to your voice, such as a deeper pitch
• Feeling that you have a lump in your throat
• Difficulty swallowing
• Chronic sore throat
• A burning feeling in the throat
• Feeling the need to clear your throat regularly
• Extra mucus or phlegm in the throat
• Postnasal drip
• Chronic cough
• Laryngitis
• Wheezing
• Asthma
• Choking sensation
• A bitter taste in the mouth

How Doctors Can Tell That You Have Silent Reflux

Often, an otolaryngologist (ear, nose and throat doctor) diagnoses silent reflux. They learn about your symptoms and look in your mouth and inside your throat.

• Doctors use a tool called a laryngoscope to view your throat from within. They insert this thin, flexible tube with a camera into the nose for assessment.
• Redness, inflammation or excessive mucus in the throat may make doctors suspect silent reflux. In some cases, doctors offer other tests to confirm their suspicions.

“Doctors may perform an upper endoscopy to view the throat and esophagus from within and determine if there is inflammation or a structural cause, such as a hiatal hernia.” Dr. Benzie says. “They may also test the acid level and/or the muscle pressure within your esophagus.”

How to Find Relief From Silent Reflux

Unfortunately, some people with silent reflux are never diagnosed and deal with the discomfort. They may assume that they are always sick or must cope with a chronic sore throat.

It is not necessary to live with constant throat discomfort. Once silent reflux is diagnosed, treatments are available to ease your symptoms.

Doctors may suggest lifestyle changes that may minimize acid reflux. This may prevent stomach contents from rising up to the larynx, improving throat symptoms.

To minimize silent reflux symptoms, possible lifestyle changes include:

• Eating several smaller meals throughout the day, rather than two or three bigger meals
• Staying upright (not lying down) for three hours after eating meals
• Avoiding foods that may trigger reflux, including spicy or acidic choices
• Avoiding carbonated beverages to prevent belching
• Staying well hydrated
• Cutting back on alcohol intake
• Quitting smoking and avoiding secondhand smoke (being around others who smoke)
• Wearing loose-fitting clothing, rather than items that cinch tightly around the waist
• Losing weight, if you are overweight
• Sleeping on your left side to reduce your chances of experiencing reflux at night
• Elevating the head of your bed while you sleep
• Adding honey to hot beverages, to help soothe a sore throat
• Speaking gently, in your normal range, rather than shouting or whispering

Medication is also available to help with silent reflux symptoms. Options include:

• Antacids
• Proton pump inhibitors
• H2 blockers
• Alginates

If lifestyle changes and medication do not provide relief, procedures are available to address silent reflux. These include:

• Transoral incisionless fundoplication (TIF)
• Minimally invasive hiatal hernia repair with fundoplication

“Silent reflux doesn’t have typical reflux symptoms, but both reflux treatments are the same,” Dr. Benzie says. “Most patients should see improvement in their symptoms by adopting lifestyle changes and working with a reflux specialist to consider medication or procedures to address their symptoms.”

Next Steps & Resources

• Meet our source: Annie Laurie Benzie, M.D.
• To make an appointment with Dr. Benzie, or a doctor near you, call 800-822-8905 or visit our website.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.