Laryngopharyngeal reflux (LPR), commonly known as silent reflux, affects the voice box (larynx) and throat without the familiar symptom of heartburn. Unlike GERD (Gastroesophageal Reflux Disease), which irritates lower esophagus and typically causes chest burning, LPR reaches higher into the throat and voice region, causing distinct symptoms that often go unrecognized.
Patients with silent reflux may experience hoarseness, chronic throat clearing, a persistent cough, or the sensation of a lump in the throat. Other signs include frequent sore throat, difficulty swallowing, wheezing, postnasal drip, and even vocal fatigue.
Because LPR seldom causes chest burning, many misunderstand these as upper respiratory or voice strain issues rather than reflux-related.
Some cases include dental symptoms: repeated exposure of tooth enamel to stomach acid can erode enamel, causing increased sensitivity, decay, and even structural damage.
In this Instagram Reel titled "Sensitive Teeth? Try Fixing Your Acid Reflux Instead", by Dr. Joe Damiani, a TMJ and ENT specialist, explains a lesser-known link between gastric reflux and tooth sensitivity. It explains that stomach acid reaching the mouth can weaken tooth enamel over time. Reversing or managing reflux may help reduce dental sensitivity—an important insight for people not experiencing typical heartburn yet still facing oral discomfort.
Silent reflux occurs when stomach contents ascend beyond the esophagus into the larynx and pharynx, typically due to dysfunction of the upper esophageal sphincter. The tissues in the throat and voice box are more fragile than those in the esophagus and can sustain inflammation even from small amounts of acid.
Pepsin, an enzyme from the stomach, can remain lodged in throat tissues and cause ongoing damage. Even without acid directly present, pepsin can reactivate upon further reflux episodes, damaging voice tissue at a molecular level.
Typical triggers include tobacco, alcohol, fatty or spicy foods, obesity, overeating, tight clothing, and lying down soon after meals.
Silent reflux often requires evaluation by an otolaryngologist. Diagnosis may involve a laryngoscopic examination to detect throat inflammation, and tests like endoscopy or esophageal pH monitoring to confirm acid exposure.
Clinicians recommend lifestyle modifications as the first line of treatment. These include avoiding trigger foods, eating smaller meals, not lying down for at least three hours after eating, quitting smoking, elevating the head during sleep, and reducing alcohol consumption.
Medications such as proton pump inhibitors, H2 blockers, antacids, or alginates may help reduce acid exposure.
In more persistent cases, surgical interventions or minimally invasive procedures (e.g., fundoplication) may be considered to tighten the sphincter mechanism.
Note: This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits.
(Rh/Eth/TL/MSM)