You’ve probably never heard of silent reflux, but for many Americans, it’s an uncomfortable, and even deadly condition — one that often goes undiagnosed. Silent reflux is laryngopharyngeal reflux or LPR. Unlike normal acid reflux, where acid invades other parts of the digestive system, with silent reflux, stomach acid invades the respiratory system.

“[LPR] encompasses acid reflux into all parts of the airway, including the nose, sinuses, voice box, throat, trachea, bronchi and lungs.”

Source: Dr. Jamie Koufman, director of the Voice Institute of New York via U.S. News

What are Silent Reflux Symptoms?

Unlike typical acid reflux, silent reflux doesn’t give you a burning sensation or indigestion. Often, you don’t even feel it in your digestive system. Silent reflux is often mistaken for an allergy or a respiratory problem. You may have silent reflux if you notice that your voice is hoarse or you have a chronic cough. Trouble swallowing, a need to clear your throat, sore throat or trouble breathing are also signs of silent reflux. Also, if you feel as though something is always stuck at the back of your throat, you may have the digestive disorder.

Also, in children and babies, watch for a chronic cough that sounds like a bark. They may spit up their food or have trouble eating any food at all. Hoarseness, noisy breathing, apnea, asthma or difficulty gaining weight are also all signs that your baby may have silent reflux.

Why People Get Silent Reflux

LPR is caused by a weak or damaged lower esophageal sphincter. For many, it’s caused by regularly overeating, which results in a distended stomach. Obesity makes the situation worse. To put it simply, in a distended stomach surrounded by fat, there is no room for the acid to go, so some can reach the upper airways.

Silent reflux is also common in infants because they spend much of their time lying down and they have a shorter esophagus.

Is Silent Acid Reflux Dangerous?

Silent acid reflux can cause esophageal cancer, which is the fastest growing cancer in the nation. It can also cause sleep apnea. It can even damage your voice.

Acid Reflux and the Laryngopharynx

silent reflux

Image: CC by 4.0 International, by Sémhur, via Wikimedia

The laryngopharynx is sort of a hybrid organ located between the larynx, the hyoid bone, and the esophagus. It is part of the pharynx, and its job is to guide food and air to its respective places in the body. It’s also a key component in your voice.

When the sphincter at the back of the esophagus becomes weak or damaged, enough stomach acid can back up that the laryngopharynx allows it to enter the respiratory system.

How to Get Rid of Acid Reflux in Throat

Many symptoms of acid reflux can be addressed through lifestyle changes. If you are overweight, lose weight. Try to eat a low fat, higher alkaline diet with plenty of fruits and vegetables. Avoid eating fewer than three hours before bedtime, and take a walk after eating to help ease digestion.

Doctors also advise quitting smoking, chewing gum to stimulate the saliva and don’t wear tight clothes that constrict the waist.

Diet and silent reflux

silent reflux

Image: CC by 2.0, by Arya Ziai, via Flickr

For most people, simple dietary changes are all that’s needed to control acid reflux. Limit meat, dairy, and high-fat foods. Chocolate, tomatoes, and onions can add to the acid in your system. You should also cut back on caffeine, especially late in the day. Avoid citrus, alcohol and carbonated beverages. Processed foods, and in particularly canned foods, may have additives like citric acid and ascorbic acid that can worsen your symptoms.

Instead, eat alkaline foods, such as avocados, grapefruits, leafy greens, most vegetables, sweet potatoes, carrots, cucumbers, and bananas. Mint is an alkaline food, but surprisingly, it can make symptoms worse. Here is a complete list. 

Supplements to tame acid reflux

If diet alone doesn’t cure your acid reflux, some vitamins and natural supplements might help. In a 2006 study, participants were divided into two groups. Group A took a supplement containing B-6, folic acid, B-12, L-tryptophan, methionine, betaine, and melatonin.

Group B took omeprazole (an over the counter medication marketed as Prilosec or Losec, among others). 100 percent of Group A’s participants found relief after 40 days. Only about 65 percent of Group B’s found significant improvement. Other supplements that might help include digestive enzymes at the start of each meal and daily probiotics. You may also try HCL with pepsin before each meal, magnesium twice a day and papaya, ginger, or apple cider vinegar.

Exercise and silent acid reflux

silent reflux

Image: Public domain, by Amanda Mills, via FreeStockPhotos

Exercise is a critical part of a healthy lifestyle, and if you’re trying to lose weight to minimize acid reflux, it’s almost a must. However, some exercises can exacerbate symptoms, especially if done on a full stomach. High-impact activities, such as running, weightlifting, cycling, jumping rope and stair-climbing, may even cause acid reflux by forcing air into the esophagus. Avoid hanging upside down or bending over for extended periods of time.

Instead, focus on lower-impact exercises such as swimming, stationary biking, walking, and light jogging. Yoga can also be helpful, as long as you don’t spend too much time in inverted poses.

One simple treatment is to elevate your head about 4-6 inches while you sleep. You can purchase a bed that will raise your head, or you can buy a wedge.

When to see a doctor about your silent reflux symptoms

There are times you may need more than home care for your silent reflux. Call your doctor if you:

  • Find your symptoms become more severe, despite changing your diet and exercise regimen
  • Have difficulty swallowing
  • Begin vomiting (especially blood or black material)
  • Cancel activities or find life less enjoyable
  • Have black or bloody stools, or diarrhea
  • Are experiencing unexplained and dramatic weight loss
  • Experience chest pain, pain in the neck, jaw or legs; shortness of breath, irregular pulse, sweating, or weakness
  • Can’t find relief from over the counter medications

If you can’t find comfort, your doctor might recommend surgery. Fundoplication is generally arthroscopic. It involves wrapping the upper part of the stomach around the lower esophagus, which creates a stronger valve. There are other arthroscopic options as well.

And remember, untreated, acid reflux can cause cancer or other irreversible conditions.

Medications for silent reflux

There are several medications on the market to treat acid reflux, and many are available over the counter.

You can treat mild acid reflux with simple antacids, such as Tums, Maalox, Mylanta and, Rolaids. Take them at the onset of symptoms. Over the counter antacids work well for acute (occasional) acid reflux symptoms, but they may not be ideal for chronic cases. Oral suspension medications, such as Pepto Bismol may also help.

Other over the counter medications include H-2-receptor blockers, such as Pepcid AC and Zantac. They stop your stomach from producing acids. They should only be used by people who just suffer occasionally. Proton Pump Inhibitors, such as Prevacid and Nexium, block acid production. They are recommended for more chronic sufferers.

If the over the counter medications don’t work, see your doctor. She may prescribe stronger versions.

Go See Your Doctor

Everyone experiences occasional heartburn, and for most, it’s not a problem. When, however, it affects your lifestyle or your ability to breathe, it’s time to change your diet or seek treatment. Most acid reflux, including the silent kind, is very treatable, as long as you get to it before it causes permanent damage.


Featured image: CC by 2.0, by Eric Chan, via Flickr