For most of us, once we eat, digestion begins without the contents of the stomach coming back up again (refluxing). The term Laryngopharyngeal Reflux (LPR) is a specific type of reflux whereby the backflow of stomach contents reflux all the way back into the voice box or throat. LPR can occur during the day or night, even if a person has not eaten anything. A person with LPR may never even experience the typical heartburn symptoms. This is one reason why LPR is called "silent reflux." Often overlooked and misdiagnosed, silent reflux affects over 50 million Americans.
Even though a person with silent reflux may not have some of the more typical symptoms usually associated with typical heartburn, silent reflux can still wreak havoc on a system. The esophagus, ears, nose, throat, vocal cords, sinuses, mouth and lungs can all be impacted. Many with silent reflux have been misdiagnosed with sinusitis, sleep problems, and even asthma. More importantly, silent reflux can lead to Barrett’s esophagus and esophageal adenocarcinoma even in patients who lack the more common symptoms of acid reflux (Fass, 2006).
Some with silent reflux experience frequent throat clearing, a constant cough, hoarseness or frequent night awakenings. Bad breath may also be a symptom of silent reflux. In babies, silent reflux can be especially difficult to manage, because if a parent is receiving care from a physician who is not familiar with silent reflux, then the doctor may ask the parent only questions related to typical reflux symptoms, thereby dismissing LPR as a diagnosis if the parent answers negatively to the questions. Instead of treating the baby for reflux, the doctor may continue to treat the infant for ear infections or other easily mistaken disorders.
The good news is that once a correct diagnosis is made, effective anti-reflux treatment can help silent reflux. Proton pump inhibitor (PPI) therapy can be very effective in the treatment of silent reflux. Other non-medical therapies such as not eating before bedtime or putting your bed on a slant so gravity can help keep stomach contents down can also make a difference. The most important first step in the treatment is to get to a physician who is familiar with silent reflux and knows how potentially dangerous the disorder can be.