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What Is Silent Reflux?

Your team held a goodbye happy hour for a co-worker who’s moving on, and despite your best intentions, you indulged a little too much.

There were delicious appetizers, sugary cocktails, and of course, cake. You just couldn’t say no, and you ended up stuffing yourself full. On the way home for the evening, you realize you’re pretty uncomfortable.

No, it’s not just the fact that you’re sluggish and your pants are a little snugger than when you arrived. You feel like you have a lump in your throat, and even excessive swallowing and throat clearing isn’t helping.

If you’re like most people, you write it off as allergies or early cold symptoms. But in reality, it could actually be silent acid reflux.

What’s the difference between silent acid reflux and regular acid reflux?

The term “acid reflux” or GERD typically inspires thoughts of things like heartburn, bloating, and indigestion.

But, that’s not always the case with silent reflux. The symptoms are the main difference between silent and regular acid reflux.

“The reason it is called silent reflux is because there are no classic acid reflux symptoms,” says Gil Weitzman, gastroenterologist and Evens medical advisor. “However, patients may find other symptoms that are associated with acid reflux, namely symptoms of laryngopharyngeal reflux (LPR).”

What are the common symptoms of silent reflux?

So, if you’re not going to be battling with traditional heartburn, how can you recognize silent reflux? What exactly are laryngopharyngeal reflux (LPR) symptoms—beyond just a mouthful?

As the laryngopharyngeal name implies, most of the telltale symptoms of silent reflux have to do with the larynx (more commonly known as your voice box) and the back of the throat.

“These symptoms can include a chronic cough, a lump in the throat sensation, excessive throat clearing, or voice hoarseness,” says Weitzman. A chronic cough, in particular, is one of the key indicators of silent reflux, and is often referred to as acid reflux cough.

What causes silent reflux?

While the symptoms of silent reflux are different, it does tie back to the same causes as regular acid reflux: stomach acid heading the wrong way. Your lower esophageal sphincter malfunctions and allows stomach acid to move backward into your esophagus and throat—rather than staying where it belongs.

As Johns Hopkins Medicine explains, when enough stomach acid moves up from the stomach and into the esophagus and throat, it can cause irritation and discomfort—hence the sore feeling, throat clearing, and chronic cough.

Studies have also shown that the presence of a hiatal hernia is also significantly associated with silent reflux as well as other more traditional GERD-related symptoms.

Lastly, according to Harvard Medical School, somebody with a hiatal hernia has a part of their stomach that won’t stay in place. In a hiatal hernia, a piece of the stomach slips through the hiatus (that’s the diaphragm opening between your chest and stomach), moves into the chest, and can cause a slew of both silent and regular reflux-related symptoms.

How do you treat silent reflux?

LPR can be uncomfortable. So, you don’t just want to understand what’s happening with your body—you want to know how you can treat it.

The good news is that there are a variety of treatment options available, and they fall into the following two buckets:

Medication

For those who are really struggling with LPR symptoms, the Cleveland Clinic shares that over-the-counter medications such as antacids, H2 blockers, or proton pump inhibitors (PPIs) can provide some relief.

Take all medications as directed, and be prepared to be a little patient. The American Academy of Otolaryngology-Head and Neck Surgery Foundation says that it can take two to three months of medications to see effects.

However, if you aren’t seeing any improvement in your symptoms, you might want to speak to a doctor. In some severe cases of LPR, surgical intervention might be necessary—but, rest assured, it’s not common.

Lifestyle Changes

Medications can be helpful, but they aren’t your only option to do away with that discomfort in the back of your throat. Various lifestyle changes can be effective—and in many cases, even preventative.

When it makes sense, avoid food and drinks (such as spicy, acidic, or fatty foods and caffeine and alcohol) that are known reflux triggers for you.

Additionally, resist the urge to go overboard and instead eat smaller meals. When your stomach isn’t as full, your lower esophageal sphincter will have an easier time keeping your stomach acid where it belongs. Also, say “no” to the midnight snacks and stop eating at least two hours before you head to bed.

If you’re overweight or a tobacco user, it’s probably not news to you that shedding some pounds and stopping smoking will improve your general health. However, it can also help with your silent or regular acid reflux symptoms.


There’s a reason LPR is referred to as silent reflux—it’s not as easy to recognize, especially if you’re on the lookout for symptoms that are more commonly associated with traditional reflux (like heartburn, for example).

So, the next time you find yourself overindulging at a work happy hour and end up paying for it with a sore, uncomfortable throat, keep this advice in mind so that you can figure out how to get yourself some much-needed relief.

Or, when in doubt, you can also keep yourself in check and enjoy just one slice of that chocolate goodbye cake instead of two (because, yes, we definitely saw that second piece you snuck when you thought nobody was looking).


The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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