What is silent reflux?

Many people are familiar with gastroesophageal reflux disease, or GERD. GERD is commonly known as heartburn, and the National Institute of Diabetes and Digestive and Kidney Diseases says it affects about 20 percent of the population in the United States.

With GERD, acid and partially digested food from the stomach rise back up into the esophagus, which is the tube connecting the stomach to the throat. GERD can be easy to recognize thanks to some prominent symptoms, but a lesser-known condition also may be affecting millions without their knowledge.

Known as laryngopharyngeal reflux, LPR or “silent reflux,” this type of reflux results in the backflow of stomach contents, acid and digestive enzymes into the airway, according to Dr. Jamie Koufman, director of the Voice Institute of New York and clinical professor of otolaryngology at Mount Sinai. Silent reflux is sometimes referred to as “GERD cough.” Some people may not have noticeable heartburn, but may have hoarseness or a chronic cough, or feel they have something stuck in the back of their throat that needs to be cleared. Chronic post-nasal drip or feeling like there is drainage dripping from the nose into the throat also may be a symptom, states Healthline. Because silent reflux also may cause chest pain and wheezing, it may be mistaken for asthma.

Similar to GERD, silent reflux occurs when the sphincter that connects the stomach from the esophagus does not close properly. As a result, acidic stomach contents can flow back up the esophagus and even into the larynx — the hollow organ forming an air passage to the lungs. LPR also can affect the nose, sinuses, trachea, bronchi, and lungs.

LPR is often overlooked or misdiagnosed even though it affects millions of people every year, states Emory Healthcare. If left untreated, LPR can be a risk factor for esophageal cancer and cause damage to the affected areas of the body.

People will need a detailed health history, physical examination and testing, like an endoscopy, before silent reflux is diagnosed. Avoiding acidic foods, caffeine, cocktails, and carbonated beverages can help. Eating close to bedtime also can contribute to silent reflux. Medications like antacids or proton pump inhibitors also may remedy reflux issues.
Those who suspect they may be suffering from silent reflux should discuss their concerns with a physician.

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