What is Silent Reflux?

When you think of acid reflux, you probably think of heartburn and indigestion. And while it’s true that these are the hallmark signs of gastroesophageal reflux disease (GERD), in some cases, acid reflux produces neither of these symptoms. Silent reflux is a condition that often does not cause heartburn but can still be just as troublesome for your health.

Silent reflux, also known as laryngopharyngeal reflux, is a condition that affects over 50 million Americans. It is a complication that occurs when the esophageal sphincters – the muscular rings at the top and bottom of the esophagus – do not work properly. Stomach acid is then able to travel through the esophagus and into the larynx (voice box), pharynx (back of the throat), sinuses and even the nasal cavities. These areas, which are not able to tolerate gastric acid, become inflamed.

Symptoms of silent reflux may include:

  • Hoarseness
  • Persistent cough
  • Excessive throat clearing
  • Feeling of a lump in the throat that does not improve with swallowing
  • Sore throat
  • Difficulty swallowing
  • Difficulty breathing
  • Postnasal drip

Although these symptoms may appear to be nothing more than a mild annoyance, they should not be ignored. Silent reflux has been linked to serious conditions, such as asthma, bronchitis, emphysema, Barrett’s esophagus and even cancer.

If you suspect that you may have silent reflux, a trip to the doctor is in order. Your physician will evaluate your medical history, conduct a physical exam and, possibly, perform further testing. Tests for diagnosing silent reflux include:

  • Upper endoscopy – an office procedure that uses a flexible tube to examine the throat and vocal cords
  • Esophageal pH test – a 24-hour test that measures the amount of acid in your throat and esophagus

Silent reflux can often be managed through the same medications and lifestyle changes used to treat GERD. Medications such PPIs and H2 blockers can help control acid production. Sucralfate, a drug commonly used to treat ulcers, can help protect the lining of the esophagus, throat and nasal cavities. Antacids can help neutralize acid.

Lifestyle changes that may help control silent reflux include:

  • Weight loss
  • Avoiding alcohol
  • Giving up smoking
  • Avoiding “trigger” foods, such as mint, chocolate, citrus, tomatoes, spicy foods and caffeine
  • Avoid eating at least three hours before bedtime (Source:

If you are experiencing symptoms of silent reflux, don’t delay in scheduling an appointment with your doctor. Come prepared with a list of your symptoms and any questions you may have. With the proper diagnosis, you can develop an effective treatment regimen and prevent reflux from leading to bigger health issues.