Silent Reflux

UT Southwestern Medical Center’s experts in throat and digestive tract conditions have advanced training and extensive experience in treating silent reflux and related disorders. Our teams use the latest advancements to relieve symptoms and treat the causes of silent reflux, providing the best possible outcomes for patients.

Experienced Care for Silent Reflux

Silent reflux, also known as laryngopharyngeal reflux (LPR), is a condition in which stomach acid flows back up the esophagus (swallowing tube) into the larynx (voice box) and throat. LPR is called silent reflux because it often does not cause any symptoms in the chest.

Our fellowship-trained laryngologists (ear, nose, and throat doctors with specialized training in disorders of the larynx) have extensive experience diagnosing and treating silent reflux and other disorders affecting the esophagus, throat, and larynx. We usually begin with medications and lifestyle changes and then might recommend advanced minimally invasive procedures for disease that has not responded to nonsurgical treatment.

Causes of Silent Reflux

When people eat, food travels down the esophagus into the stomach, where the gastrointestinal system begins to digest it. The esophagus has a sphincter (ring of muscle) where it connects to the stomach that closes to prevent stomach contents from going up the esophagus. If the sphincter does not close properly, acidic stomach contents can flow back into the esophagus, up to the throat and larynx.

Risk factors for developing LPR include:

• Alcohol and/or tobacco use
• Certain food choices such as fried or spicy foods
• Clothing that is tight around the abdomen
• Excess weight or obesity
• Habits such as overeating or lying down just after eating

Symptoms of Silent Reflux

LPR usually does not cause chest-burning symptoms, but if symptoms do appear, they include:

• Asthma
• Bitter taste in the throat
• Chronic cough or excessive throat clearing
• Difficulty swallowing
• Hoarseness
• Postnasal drip
• Sensation of a lump in the throat
• Sore or burning sensation in the throat

Diagnosis of Silent Reflux

At UT Southwestern, our skilled laryngologists conduct a thorough evaluation, which includes a:

• Physical exam
• Review of personal medical history
• Discussion of symptoms

In some cases, we can confirm a diagnosis of LPR based on our evaluation, without any additional testing. Depending on each patient’s specific needs, we sometimes work with gastroenterologists (specialists in disorders of the digestive tract), who can help to diagnose reflux with pH, impedance, and motility testing.

When needed, additional tests might include:

• Acid reflux test: Test to measure the amount of acid in the fluid inside the esophagus
• Endoscopy: Test to view inside the throat and esophagus using a long, thin tube with a lighted camera at its tip
• Swallowing study: Test to evaluate how food moves from the mouth through the esophagus, using a special liquid called barium that shows up on X-rays

Treatment for Silent Reflux

At UT Southwestern, we typically begin treatment for LPR with lifestyle/dietary modifications and sometimes medications that reduce the effects of stomach acid, such as:

• Antacids
• Proton pump inhibitors
• H2 blockers
• Alginate therapy

More specifically, our laryngologists recommend the following lifestyle changes to help reduce the chances of reflux occurring, such as:

• Weight loss
• Avoiding acid-producing foods such as chocolate, fried foods, citrus fruits, spicy foods, and tomato-based products
• Stopping eating at least two to three hours before bedtime
• Elevating the head during sleep