What is acid reflux?

Silent reflux is a lesser-known form of acid reflux that can bring on various symptoms not typical of acid reflux. The difference between acid reflux and silent acid reflux is that acid reflux results in acid traveling back up the esophagus whereas with silent reflux acid moves into the pharynx, larynx, or voice box.
Silent reflux is a lesser-known form of acid reflux that can bring on various symptoms not typical of acid reflux. The difference between acid reflux and silent acid reflux is that acid reflux results in acid traveling back up the esophagus whereas with silent reflux acid moves into the pharynx, larynx, or voice box.

Acid reflux is a common condition. Silent reflux is a lesser-known form of acid reflux that can bring on various symptoms not typical of acid reflux.

When stomach acid continually makes its way back into your esophagus, the tube that connects your stomach and mouth, you have acid reflux. Frequent exposure to stomach acid can harm your esophagus. Also known as gastroesophageal reflux disease (GERD), you could experience acid reflux occasionally or as often as a few times per week.

Symptoms of acid reflux

If you have acid reflux, you might experience:

  • Heartburn, a burning feeling in your chest that usually occurs after eating and at night
  • Pain in your chest
  • Difficulty swallowing
  • Regurgitated food or an acidic liquid
  • Feeling like there’s a lump in your throat

If your acid reflux affects you at nighttime, you could also have the following symptoms:

Causes of acid reflux

At the base of your esophagus, there’s a band of muscle called the lower esophageal sphincter that relaxes as you swallow. This is what allows food and liquid to travel to your stomach. Then, it tightens to close the opening and prevent stomach acid from reaching your esophagus. Suppose this muscle weakens or begins to relax abnormally. In that case, stomach acid will be able to flow into your esophagus, irritating its lining and resulting in inflammation. 

Treatment of acid reflux

If you experience chest pain, difficulty breathing, or pain in your jaw or arm, you should get immediate medical care. You could be having a heart attack. Suppose you have frequent symptoms of GERD or have to take over-the-counter heartburn medicine multiple times a week. In that case, you should make an appointment with your healthcare provider.

What is silent reflux?

Silent reflux also happens due to stomach acid moving backward toward the throat. However, the stomach acid will travel up the esophagus and into the pharynx, larynx, or voice box. People with silent reflux usually don’t know that they have this condition, also known as laryngopharyngeal reflux (LPR).

Symptoms of silent reflux

If you have silent reflux, you might experience the following symptoms:

  • Frequent throat clearing, particularly after eating or in the morning
  • Excessive dry coughing
  • Sore throats independent of another illness
  • Feeling hoarse
  • Feeling like there’s a lump in your throat
  • Excessive, thick mucus
  • Issues with your voice

Treatment of silent reflux

If you have LPR, you could focus on diet, behavior, and acid-blocking medications to treat your condition.

Diet

Certain foods worsen silent reflux that you should avoid or drastically cut back in order to help your body heal.

  • Caffeine, alcohol, chocolate, and peppermint reduce the effectiveness of your lower esophageal sphincter.
  • Citrus, kiwi, pineapple, tomato, other foods high in acid, and spicy meats and spices (like hot mustard, curry, and hot peppers) will further irritate your esophagus. 
  • Carbonated drinks like soda or beer are too acidic for your throat. You should avoid both caffeinated and non-caffeinated beverages.

Even if you’re taking medicine and other preventative measures, consuming these foods will worsen the irritation and inflammation in your esophagus.

Behavior

After you eat, don’t bend over, exercise, sing, or take part in any activity that increases pressure in your midsection. Try eating multiple small meals instead of three large meals in a single day. Avoid lying down until at least three hours after your last meal. This means you shouldn’t snack or drink right before you go to bed. If you still experience issues, prop your head up with pillows so that gravity can work to keep whatever you consumed in your stomach.

Medications

Ask your healthcare provider before starting any medicines for your LPR. They might suggest:

  • Proton Pump Inhibitors — This is one of the most effective treatments for silent reflux. Proton pump inhibitors keep your stomach from producing acid for 12-17 hours — This helps decrease the potential of irritating acid from rising to your esophagus.
  • Antacids — These can be taken after you eat or before you sing or exercise.
  • H2-blockers —If you have issues with your LPR at night, this antihistamine can help reduce the production of stomach acid while you sleep.

Throat-clearing alternatives

When possible, try to avoid clearing your throat and coughing. Your esophagus needs to be left alone to heal. If you feel like there’s a build-up of mucus or other material in your throat, try these alternatives to clearing your throat:

  • Swallow
  • Take a drink of water
  • Silent cough (pushing a large amount of air from your lungs in a quick, short blast) and then swallow

Seek professional help

A medical specialist will be able to diagnose and treat your acid reflux or silent reflux. Consider asking these questions:

  • Will over-the-counter medicine help reduce symptoms?
  • What else can be done to reduce or limit symptoms?
  • Is this condition indicative of a bigger issue?

If you think you have acid reflux vs. silent reflux (LPR vs. GERD), get in touch with your healthcare provider.

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Medically Reviewed on 1/7/2022
References
Sources:

American Academy of Otolaryngology–Head and Neck Surgery Foundation: "GERD and LPR."

Mayo Clinic: "Gastroesophageal reflux disease (GERD)."

Stanford Medicine: "Laryngopharyngeal Reflux (LPR) Protocol."