What is Silent Reflux ?
Silent Reflux happens when your stomach contents (refluxate) travel back up the food pipe (oesophagus) and right up into the back of the throat (pharynx) and the tissues around the voice box (larynx).
Persistent Cough
Constant throat clearing
Sensation of lump in the throat
Thick mucus at the back of the throat
Hoarseness and voice changes
Lots of people with Silent Reflux don’t realise they have it. And it can get missed by health professionals. That’s because Silent Reflux symptoms:
- Crossover with symptoms of other conditions like colds or allergies.
- Don’t match the more well-known forms of reflux.
What’s the difference between Silent Reflux and GORD?
Reflux has two distinct forms:
- Silent Reflux (Laryngopharyngeal Reflux, LPR)
- Gastro-oesophageal reflux (GORD)
1 in 5 people have some form of gastric reflux. And about half of the people with gastric reflux have both Silent Reflux and GORD.
Around 40% of people with silent reflux can also experience GORD. However, people can experience symptoms of silent reflux without any heartburn or indigestion.
Comparing the symptoms of Silent Reflux and GERD/GORD
A Definite Contrast!
Silent Reflux Symptoms
- Breaches upper oesophageal sphincter
- Hoarseness, globus, thick mucus, postnasal drip and throat pain due to inflammation
- Symptoms are worse when upright
- Patient usually deny heartburn and reflux
- Not associated with obesity
GERD/GORD Symptoms
- Breaches only lower oesophageal sphincter
- Acid reflux, heartburn and chest pain, only occasional throat pain symptoms
- Symptoms are worse when lying down
- Patient report heartburn and reflux
- Associations found with obesity
What causes Silent Reflux ?
The exact cause of Silent Reflux is not yet fully understood. But experts know that the stomach contents contain chemicals (acids, bile and enzymes) that can cause damage to tissues lining the mouth, throat and upper airways.
Your stomach contents are usually stopped from going back up the food pipe by a tight band of muscle between the food pipe and stomach (the lower oesophageal sphincter).
Sometimes, this band of muscle relaxes at the wrong moment or does not function as it is meant to and allows stomach contents (refluxate) to go right back up the food pipe.
How does the band of muscle at the top of the food pipe contribute to Silent Reflux ?
There’s another band of muscle at the top of the food pipe, that can also squeeze tight to stop any stomach contents from reaching the throat or mouth. This is called the upper oesophageal sphincter.
This can cause the various symptoms of Silent Reflux.
How to manage symptoms of Silent Reflux ?
Lifestyle changes can help reduce the severity and frequency of Silent Reflux symptoms. These include things like:
- Increase fibre (vegetables and fruit) in the diet
- Avoid spicy foods, alcohol and large meals at least 3 hours before lying down
- Reduce coffee, tea and chocolate
- Elevate the head of the bed
- Avoid strenuous activities like heavy lifting
- Weight reduction and regular exercise
Some products — like alginates, antacids and acid reducers — can be helpful for heartburn and indigestion.
But people with LPR (silent reflux) alone may need other strategies to help with the uncomfortable symptoms.
Learn about LARRI –
triple-action Silent Reflux symptom relief
FAQS
How is Silent Reflux different to other types of gastric reflux?
Symptoms of Silent Reflux differ to symptoms of GORD (gastro-oesophageal reflux disease).
Symptoms of Silent Reflux include:
- Persistent cough
- Sensation of a lump in throat
- Constant throat clearing
- Thick mucus at back of throat
- Voice changes/hoarseness
Symptoms of GORD include:
- Heartburn
- Indigestion
What lifestyle changes can I make to manage Silent Reflux?
Lifestyle changes can help reduce the severity and frequency of Silent Reflux symptoms. These include things like:
- Increase fibre (vegetables and fruit) in the diet
- Avoid spicy, fried or acidic foods, alcohol and large meals at least 3 hours before lying down
- Reduce coffee, tea and chocolate
- Elevate the head of the bed
- Avoid strenuous activities like heavy lifting
- Weight reduction and regular exercise
When should I see a doctor about my symptoms
If your symptoms persist, worsen or change unexpectedly, talk to your health professional.