Also known as silent reflux, laryngopharyngeal reflux occurs when there is a retrograde (backward) movement of acid and stomach enzymes into the throat. Unlike gastroesophageal reflux disease (GERD), which often presents with a burning in the chest, laryngopharyngeal reflux is called silent reflux because patients experience no symptoms. Only around 35 percent of patients with laryngopharyngeal complain of symptoms. However, laryngopharyngeal reflux should be treated, as it can affect the quality of life or cause further complications, such as the formation of ulcers in the mouth or granulomas (masses) in the throat.
The cause of acid reflux is dysfunction of the lower esophageal sphincter (LES). This is a muscle that manages the opening between the stomach and esophagus. When a person without reflux eats or drinks something, the muscle opens to let what was ingested pass through and then closes tightly. In a person with laryngopharyngeal (or GERD), the muscle does not close properly, and stomach acid and enzymes enter the esophagus and bubble up in your throat.
Anyone can develop laryngopharyngeal reflux, regardless of age, gender, or ethnicity, but certain risk factors that predispose you to develop silent reflux. These include:
Only around 35% of those with the condition report symptoms. Those who do develop symptoms feel them predominantly in the throat. These include:
Some of these symptoms are also present in other conditions, such as the common cold. However, if your symptoms persist for more than a few days, contact your gastroenterologist or physician for a visit.
Your physician will do a quick, noninvasive physical inspection of your throat and ask about your symptoms. If they suspect laryngopharyngeal reflux, they may order certain diagnostics to confirm or deny the suspicion. Some of the tests used to diagnose silent reflux include:
The first-line treatment for laryngopharyngeal reflux is a lifestyle change. Your doctor will tell you to avoid peppermint, chocolate, caffeine, tobacco, and alcohol, as these all weaken the LES. Citrus fruits, acidic food, and spicy food can also aggravate symptoms. Carbonated beverages can also trigger the dysfunction of the LES. Your physician may also advise you to:
Rarely, if laryngopharyngeal reflux is severe, surgery is utilized as a treatment method.
If silent reflux is treated, the outlook is positive, as laryngopharyngeal reflux is typically managed with lifestyle and behavioral changes. However, if silent reflux is not treated, other complications can occur, such as:
If left untreated, the most severe cases of laryngopharyngeal reflux can develop into cancer of the larynx.
To minimize your chances of developing laryngopharyngeal reflux, you should limit chocolate, caffeine, alcohol, and carbonated beverages. Spicy and fatty foods and smoking tobacco can both contribute to silent reflux. You can also manage stress appropriately, wear loose-fitting clothing, and maintain a healthy weight to minimize the risk of laryngopharyngeal reflux. Also, don’t eat two hours before bedtime. This is standard good practice, as even someone without reflux or gastrointestinal disturbances can develop heartburn if they immediately lie down after eating.
