Acid reflux is a common digestive issue experienced by everyone at least once in their lifetime. Common triggers include fatty, fried, spicy, and acidic foods; beverages like coffee and alcohol; and lifestyle factors, such as being overweight, smoking, and lying down after eating. Acid reflux is usually noticeable, with issues like a burning sensation in the chest, also known as heartburn, regurgitation – when stomach content returns back to the oesophagus – and a sour or bitter taste in the mouth. However, did you know that a reflux can also be silent?
In an interaction with the OnlyMyHealth team, Dr GS Sameer Kumar, Consultant Medical Goutroenterologist, Hepatologist, and Interventional Endoscopist, Gleneagles Hospital, Lakdi-Ka-Pul, Hyderabad, explains what silent reflux is, how it can be diagnosed, and ways to treat it.
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What Is Silent Reflux?
“Silent reflux is a condition where stomach acid travels up the oesophagus and reaches the throat and voice box, often without the classic symptoms of heartburn,” explains Dr Kumar. That’s why it’s called ‘silent’, as many people don’t realise it’s happening.
Unlike typical acid reflux, or Gastroesophageal Reflux Disease (GERD), which causes a burning sensation in the chest, silent reflux, also known as Laryngopharyngeal Reflux (LPR), tends to affect the upper airways and vocal cords more than the oesophagus.
Can Silent Reflux Be Mistaken For An Allergy?
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According to Dr Kumar, silent reflux can often cause chronic cough, throat clearing, a sensation of a lump in the throat, hoarseness, post-nasal drip, or even shortness of breath, symptoms that are commonly associated with asthma or seasonal allergies. This can lead to a misdiagnosis or delayed diagnosis.
In some cases, people with silent reflux may be treated for asthma or sinusitis for months before the actual cause is discovered.
Another explanation behind the misdiagnosis can be Eosinophilic Esophagitis (EoE), a chronic allergic/immune condition of the oesophagus characterised by the presence of a large number of eosinophils, a type of White Blood Cell (WBC), in the oesophageal lining. Both seasonal allergies and acid reflux can trigger EoE, according to the American College of Allergy, Asthma & Immunology, with the main symptom being difficulty swallowing.
How To Diagnose Silent Reflux If Symptoms Are Not Obvious?
According to Dr Kumar, a laryngoscopy can help visually examine the throat and voice box for a silent reflux. Additionally, pH monitoring can help track acid levels over 24 hours, and you can also fill out reflux symptoms index questionnaires.
Moreover, a blood test as well as a skin test can rule out any allergies that may have been missed.
Also Read: Gastric Reflux In Infants And Children: Causes, Red Flags, And Treatment Options
Treatment Options And Management Strategies
For immediate relief from reflux symptoms, Dr Kumar recommends:
- Proton Pump Inhibitors (PPIs) or H2 blockers to reduce acid production
- Antacids, in some cases
- Voice therapy or ENT-guided care if the voice box is inflamed
- But lifestyle plays a major role in managing silent reflux. These include:
- Avoid trigger foods like caffeine, spicy and acidic foods, chocolate, and alcohol.
- Eat smaller meals, and don’t lie down for 2-3 hours after eating.
- Raise the head of the bed to prevent nighttime reflux.
- Quit smoking if applicable.
- Maintain a healthy weight.
Conclusion
Silent reflux is a condition that occurs when stomach content flows up the oesophagus, affecting the throat and voice box. Its common symptoms often mimic allergies and asthma symptoms, which leads to delayed diagnosis. Therefore, if you experience persistent sore throat or hoarseness, especially in the morning, or find yourself frequently clearing your throat or coughing, especially after eating spicy, fatty foods or drinking carbonated beverages, consult a doctor for further evaluation.