Laryngopharyngeal reflux (LPR) or silent acid reflux is one of the most common disorders of upper airway inflammation, as it’s estimated to have affected over 50 million Americans. However, the condition is often overlooked and misdiagnosed as gastroesophageal reflux disease (GERD).
In this article, let’s learn about silent acid reflux and how its complications might adversely affect your health.
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What Is Silent Acid Reflux?
Silent acid reflux, also known as laryngopharyngeal reflux (LPR), is the condition causing irritation in the larynx or the throat due to the backflow of stomach acid.
Functionally, the lower esophageal sphincter muscle (LES) works as a valve to prevent acid and stomach contents from entering the esophagus. But when the sphincter muscle relaxes at the wrong time, the stomach acid can flow back into the food pipe, up to your throat, the larynx, and even the nasal passage. This results in inflammation in these areas as they aren’t coated with gastric mucus to protect themselves from gastric acid.
Silent acid reflux is more prevalent among infants. They have underdeveloped sphincter muscle, shorter esophagus and spend much of their time lying down.
What Causes Silent Acid Reflux?
As discussed earlier, silent acid reflux results from dysfunctional sphincter muscles making acid bubble into the throat. But, there are also a few risk factors responsible for developing silent reflux include:
- Too much fried or spicy foods
- Tight clothes around the abdomen
- Alcohol and tobacco abuse
- Overeating or lying down right after eating
- Obesity or overweight
- Stress
Symptoms Of Silent Acid Reflux
Many people can’t distinguish between silent acid reflux and gastroesophageal reflux disease (GERD). Despite sharing the same symptoms, two digestive conditions are not quite the same thing. While GERD causes frequent heartburn sensations, silent acid reflux symptoms aren’t obvious, leading to a more challenging diagnosis. The symptoms of silent reflux may include:
- Difficulty swallowing
- Sore throat
- Chronic cough and frequent throat clearing
- Excess throat mucus
- A strained, raspy voice
- Breathing disorders (apnea)
- Feeling like a lump is stuck in the throat (known as Globus)
- Choking episodes, especially at night
It’s worth noting that some people who suffer silent acid reflux don’t have heartburn at all since the condition affects the larynx rather than the esophagus, as with GERD. If left undiagnosed and untreated, silent acid reflux in adults can adversely affect the larynx and the throat as they aren’t made to tolerate acid at all.
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Diagnosis Of Silent Acid Reflux
Based on a throat exam and evaluation, most doctors can confirm a silent reflux diagnosis. However, if needed, the doctors will need to perform specialized tests. The tests might include:
- Acid reflux test (esophageal pH test): A test to measure the amount of acid in the food pipe and the throat over 24 hours.
- Endoscopy: The doctor will insert a long, thin tube with a lighted camera at the tip to view the esophagus and the throat.
- Swallowing test: An X-ray test will be performed in which the patients will swallow a liquid called barium to coat the esophagus and the stomach so that they can become visible on the X-ray machine.
How Is Silent Acid Reflux Treated?
Treatment for silent acid reflux should be personalized. It’s either medications or lifestyle adjustment, or sometimes both depending on your doctor’s best judgment. In some cases, the doctor might suggest a surgery called Laparoscopic Fundoplication to reduce reflux.
1. Medications
Commonly, treatments for GERD can also work out for silent reflux as they reduce acid production in the stomach. Plus, OTC medications like antacids can also help you treat silent reflux by preventing the acid from bubbling into the esophagus. If the symptoms don’t go away, the doctor might prescribe acid-blocking tablets called Proton Pump Inhibitors (PPI) to lower acidity in 6-8 weeks. However, PPI can be too strong for some patients, so Ranitidine or Cimetidine are occasionally used instead.
2. Lifestyle changes
Making a lifestyle change is also an excellent way to manage silent acid reflux. Avoid these foods and drinks to help control sphincter muscles and decrease acid production.
- Spicy and fatty, fried foods
- Carbonated and caffeinated beverages
- Acidic foods like citrus juices and fruits
- Alcohol, particularly in the evening
- Chocolate
- Cheese, butter, and eggs
- Red meat
In addition, learn how to manage your stress as studies have shown that high-stress levels can upset your digestive system. Most importantly, quitting smoking and engaging in physical activities can also help you avoid experiencing unwanted reflux.
What Kind Of Problems Can Silent Acid Reflux Cause?
Chronic silent reflux can cause complications, such as breathing problems (asthma or bronchitis), long-term irritation, tissue scarring, ulcers, choking episodes, and noisy breathing. Even worse, though uncommonly, it may increase the risk of cancer of the esophagus, the voice box (larynx), the throat, or the lungs.
If you experience chronic symptoms like throat clearing and frequent cough, visit your doctor for early diagnosis and treatment. Despite hiding in plain sight, silent reflux might prevent you from enjoying life if left untreated. At the same time, focus on removing your food triggers to neutralize your stomach acid. That way, you can actively improve the health of your throat and voice for the long haul.
If you have questions about silent acid reflux or any of the conditions discussed here, connecting with a doctor in a discrete setting has never been easier.
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