What is acid reflux?
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:
- A persistent cough
- Difficulty sleeping
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:
Treatment of silent reflux
If you have LPR, you could focus on diet, behavior, and acid-blocking medications to treat your condition.
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.
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.
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.
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:
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.
Health Solutions From Our Sponsors
American Academy of Otolaryngology–Head and Neck Surgery Foundation: "GERD and LPR."
Mayo Clinic: "Gastroesophageal reflux disease (GERD)."
Stanford Medicine: "Laryngopharyngeal Reflux (LPR) Protocol."
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Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include:
- Nausea after eating
- A feeling of fullness during or after eating
- Abdominal bloating
- Upset stomach
- Reflux laryngitis
- A tightness in the throat
- Problems swallowing
- In some people, vomiting
Causes of acid reflux and heartburn include:
- Being obese
- Slouching (poor posture)
- Medications like calcium channel blockers, theophylline, nitrates, and antihistamines
- Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate
- Increase in stomach acid
- Eating a heavy meal
- Eating before bed
The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.
Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.
American College of Gastroenterology. "Acid Reflux." 2017.
familydoctor.org. "Heartburn." Updated: Mar 2014.
National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.
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