Complete Guide To Silent Reflux Disease & How To Beat It

Silent reflux disease is also known as laryngopharyngeal reflux or LPR. This condition is a form of acid reflux that does not exhibit the classic reflux or GERD symptoms, so you don’t feel acid reflux or heartburn. If you have silent reflux disease, you can often manage the condition with diet and lifestyle changes and maybe medication. But in more severe cases, surgery may be required.

What causes silent reflux disease?

All types of reflux (silent reflux, laryngopharyngeal reflux and acid reflux) are caused by the stomach acid backing up into your esophagus or food tube.

Silent reflux is when acid moves further up your esophagus and into your voice box and throat. This is where the name laryngopharyngeal reflux comes from, with the larynx being your voice box and the pharynx being the back of your throat.

These tissues experience inflammation because of exposure to stomach acid, which causes the main symptoms of silent reflux.

Lower esophageal sphincter function (LES)

There is a valve that separates your esophagus from your stomach called the lower esophageal sphincter or LES. And it’s job is to stop food and acid refluxing back into your esophagus.

Reflux happens when the valve does not close properly and food and acid travel back into your esophagus, voice box and throat.

Weakened lower esophageal sphincter

If your LES valve does not close properly it can cause the stomach acid to travel up your esophagus and reach the back of your throat and voice box. The most common reasons for this are:

  • you have eaten too much and the valve can’t close properly
  • something has caused your LES to relax and not close properly. This could be certain foods such as fatty or fried foods, caffeine, alcohol, fizzy drinks, or smoking or medication.
  • hiatal hernia, which is when part of your stomach pushes up into your chest
  • H. pylori infection
  • high levels of pepsin, which is a digestive enzyme

Learn more about the most common foods that cause reflux.

Silent reflux disease in pregnancy

Heartburn, where acid refluxes only as far as your esophagus, is very common in pregnancy due to a lack of space and therefore more pressure on your stomach. Although silent reflux does happen in pregnancy, it is is less common than heartburn.

If you have silent reflux in pregnancy, you can usually follow the standard advice about how to cure or eliminate symptoms, but be careful and exercise common sense. For example, if you are over weight, one of the most common ways to cure reflux is to lose weight. Losing weight during pregnancy is not always recommended, so if this relates to you, check with your doctor on this one first.

10 simple home remedies for reflux that will work in pregnancy.

silent reflux in pregnancy

Celiac and silent reflux disease

Celiacs have a gluten intolerance and often experience more severe reflux, and are less likely to have success with proton pump inhibitors which is common reflux medication.

Relief from LPR for Celiacs is usually found by following a gluten free, low acid diet.

Sometimes people with LPR are unaware they suffer from gluten sensitivity, so if you seem to be doing all the right things to relieve your reflux, you could try a gluten free diet for a few weeks to see if your symptoms improve.

There is one such case recorded in a medical journal where a women, who experienced reflux, was not Celiac, but tested positive for gluten sensitivity, followed a gluten free diet. Within one week, all reflux symptoms had resolved, along with headaches, joint pain, and “foggy” mind. While more research needs to be done to prove a scientific link, it is worth trying a gluten free diet if your symptoms aren’t improving.

Risk factors for silent reflux disease

Risk factors for silent reflux include:

  • Excessive alcohol consumption
  • Smoking
  • Obesity
  • Over eating
  • Lying down too soon after eating
  • Tight clothing around your stomach

Signs and symptoms of silent reflux or LPR in children

Silent reflux or LPR is more common in children than adults because of their shorter esophagus (food tube) and underdeveloped esophageal sphincter, which is the valve that stops acid and food refluxing back into your esophagus.

The most common signs of silent reflux in children are:

  • Hoarseness
  • Noisy breathing
  • Trouble feeding
  • Spitting up

While these symptoms may seem vague, if paired with trouble gaining weight or pauses in breathing that may suggest sleep apnea, you should see your doctor to check if silent reflux is the cause.

Help your little one: know about reflux in babies and children.

silent reflux in children

Silent reflux signs and symptoms in adults

In adults, silent reflux is less common but can be the root of the symptoms, especially if the symptoms seem vague and not clearly related to reflux.

Common signs of silent reflux disease in adults are:

  • Bitter taste in the back of the throat
  • Burning sensation in the back of the throat
  • Hoarseness
  • Persistent cough or excess throat clearing
  • Feeling like there is a lump in your throat
  • Sore throat
  • Noisy breathing or pauses in breathing
  • Asthma
  • Post nasal drip
  • Difficulty swallowing

Adults with silent reflux may also have heartburn, but this is more likely in cases of GERD than of LPR. Although many of these symptoms seem vague and unrelated to reflux, if multiple symptoms are present you should get checked by a doctor to see if you have LPR.

Silent reflux and sinusitis

A large portion of sinusitis sufferers are also affected by reflux. This is caused by inflammation from silent reflux or LPR extending into your nasal cavity. If natural remedies don’t work, proton pump inhibitors, which are common reflux medication, may help you clear up both conditions.

33 proven ways to get rid of reflux naturally.

Silent reflux and anxiety or stress

Even moderate stress can have a huge impact on your reflux. And I’m not just talking about anxiety and general stress here. If you overwork your vocal chords – are performer, teacher, anyone else that talks a lot – stress could be contributing to your silent reflux.

Why meditation for reflux is the best alternative remedy to try.

Dry cough and silent reflux disease

You may have a dry cough if you have LPR or silent reflux. This happens because stomach acid flows up into your throat which irritates the lining, and can cause a dry cough.

Silent reflux disease signs and symptoms in adults

Sore throat from silent reflux disease

A sore throat is another common symptom of silent reflux. It’s caused by irritation and inflammation in your throat.

Chronic silent reflux disease

It is important to get your silent reflux or LPR under control quickly. If stomach acid is exposed to your throat and voice box it can cause long term irritation and damage.

Chronic silent reflux in children

Long term, LPR may lead to:

  • narrowing of vocal cords
  • ulcers
  • recurrent ear infections
  • build up of middle ear fluid

Chronic silent reflux in adults

Silent reflux in adults may cause:

  • scarring on your throat and voice box
  • ulcers
  • irritate asthma, emphysema and bronchitis
  • it can affect your lungs
  • increased risk of cancer in areas exposed to stomach acid

How is LPR or silent reflux different from GERD?

Gastroesophageal reflux disease, or GERD, is a common form a reflux usually characterized by:

  • Heartburn
  • Acid taste in mouth
  • Chronic dry cough at night
  • Asthma
  • Bad breath

GERD differs from silent reflux disease because the areas affected by stomach acid are different for each of these conditions. However, symptoms often overlap and it’s possible for you to suffer from both GERD and LPR. If fact, some research suggests GERD may cause LPR.

If you have GERD, it’s most often associated with heartburn, or pain in the chest, which is caused by acid refluxing into your esophagus. Whereas, with silent reflux your symptoms are more vague and you may not experience any pain. But if you do experience pain, it will be in your throat.

Silent reflux diagnosis

Silent reflux is diagnosed by an otolaryngologist or ear, nose and throat specialist, also called an ENT doctor. An ENT doctor will often work with a gastroenterologist, which is a doctor that specializes in disorders of the digestive tract. This is because the root cause of your silent reflux starts in your stomach, which is part of your digestive tract.

When you visit an ENT doctor, you can expect the following to occur:

  • review of your medical history
  • discussion of your symptoms
  • physical exam

It can be difficult to diagnose silent reflux disease because of the vague symptoms, and the fact that many of the symptoms can be attributed to other conditions. The most common methods of diagnosis beyond a physical exam are an endoscopic exam and pH monitoring.

An endoscopic exam involves a laparoscopic camera used to view your throat and vocal cords for evidence of inflammation and deterioration.

pH monitoring occurs with a small catheter passed through the nose down to your esophagus, where acid can be detected. The results are sent to a computer that you wear for usually 24 hours and then you return to have the results analyzed.

Silent reflux disease treatment

The treatment for silent reflux disease or LPR usually includes lifestyle changes, possibly medication and in more severe cases, surgery to repair your damaged LES valve.

Natural remedies for LPR in children

For children with silent reflux the first step is for you to make some simple lifestyle changes, and often the condition will resolve as your child grows.

Lifestyle changes for children include:

  • Smaller and more frequent feedings
  • Keeping the child upright for at least 30 minutes after feedings
  • Try probiotics

These simple changes will help the sphincter separating the esophagus and stomach stay closed and allow the stomach to process the contents without backing up into the throat.

Natural remedies for LPR in adults

Lifestyle changes can help reduce your silent reflux symptoms:

  • If you are overweight, you need to lose weight as this can have a big impact on your LPR
  • Eat 4-5 small meals per day
  • Try following a low acid or alkaline diet
  • Try probiotics
  • Wait at least 2-3 hours after eating or drinking before lying down
  • When sleeping, elevate your upper body and adjust your sleep position
  • Reduce stress
  • Do exercises that don’t aggravate your reflux most days
  • Avoid alcohol, or drink moderate amounts of alcohol that doesn’t cause heartburn
  • Quit smoking
  • You could also try alternative remedies.

Silent reflux diet for adults

If you are overweight or obese, losing weight can help dramatically.

A recent study found that a plant based Mediterranean diet and alkaline water will help reduce LPR symptoms more than PPI medication. A Mediterranean diet consists of lots of fruit, vegetables, healthy fats and whole grains. Alkaline water neutralizes pepsin, a digestive enzyme and acid.

A change in diet can reduce your LPR symptoms, if not cure it completely. If you’re not ready to follow a Mediterranean diet, you should at least try to avoid the following foods that are common causes of reflux:

  • Spicy foods
  • Fatty foods
  • Alcohol
  • Tobacco
  • Caffeine
  • Mint
  • Chocolate
  • Carbonated or fizzy drinks

LPR Diet Plan: 11 Quick And Easy Tips You Need To Know

silent reflux diet for adults

Medications for silent reflux and LPR

Try diet and lifestyle changes first because you are most likely to see the biggest improvements, if not complete cure.

After diet and lifestyle changes, over the counter medications such as antacids are a good next step, but you should consult a doctor to establish the best treatment plan.

The most common medications prescribed to treat silent reflux are H2 blockers and proton pump inhibitors, both of which can be used to treat adults and children.

Do your research before you consider medication because there are plenty of anecdotal reports that suggest some medications will make your symptoms worse when you stop taking them. Discuss any concerns with your doctor.

Learn more about medication for treatment of silent reflux.

Surgery

In more severe cases of silent reflux, you may need surgery to correct your malfunctioning esophageal sphincter. A fundoplication may be necessary to strengthen your valve. This procedure takes part of your stomach and wraps it around your esophagus to help reinforce your malfunctioning valve. An alternative surgery is to replace your faulty valve with an artificial one, or add an artificial reinforcement to support your valve.

Silent Reflux Natural Remedies

There are natural or herbal remedies you can try to reduce your silent reflux symptoms:

  • Deglycyrrhizinated licorice (DHL) which can soothe the mucous lining of your esophagus
  • Herbal tea such as marshmallow root (improves digestion and reduces stomach acid) or chamomile (soothes your esophagus and aids digestion)
  • Turmeric helps inflammation and digestion
  • Baking soda is a natural antacid
  • Decolorized and purified aloe vera juice has anti-inflammatory and anti-oxidant properties

FAQs about LPR and silent reflux disease

Do Tums help LPR?

Tums are antacids and they neutralize the excess acid in your stomach to prevent reflux, but remember they are a temporary fix. You can take antacids when you are experiencing reflux symptoms, or just before think you’re going to have symptoms.

Will aloe vera juice help LPR?

Decolorized and purified aloe vera juice has anti-inflammatory and anti-oxidant properties which can help your silent reflux symptoms. It works by reducing acid production in your stomach and acting as an anti-inflammatory agent, which reduces your pain.

Does vitamin D help LPR?

A small study of 38 people showed that adequate vitamin D levels may help reduce the frequency and severity of the burning, aching, soreness and lump sensation associated with LPR. If you take PPI medication for a long time, you have an increased risk of bone fractures, and vitamin D can help combat this because your body needs vitamin D to absorb calcium, which is needed for strong bones.