Could Your Sore Throat Be Caused by 'Silent Reflux'?

Contrary to its name, Laryngopharyngeal Reflux (LPR), commonly known as silent Reflux, is anything but silent. The condition is known as silent Reflux because it frequently lacks heartburn, which is the defining sign of GERD and superficial acid reflux and produces throat irritation and pain.

Due to the harm the acid does to their respiratory system, voice box, teeth, and throat, many people with LPR report a wide array of symptoms even though they do not experience heartburn.

What is Acid Reflux?

The backward movement of stomach contents, particularly stomach acid, into the esophagus is known as acid Reflux. The lower esophageal sphincter (LES), a ring-shaped band of muscle at the base of your esophagus, contributes to acid reflux.

The LES is a valve that opens to let food and liquids enter your stomach for digestion and shuts to prevent materials from flowing back up in the opposite direction. Sometimes a weak LES can't seal completely. It makes it possible for stomach acids to slowly reflux up your esophagus, eventually harming your throat and producing the well-known burning sensation.

Symptoms that you have Silent Reflux

If you have LPR, you might encounter the following symptoms −

Hoarseness- You could notice that your voice sounds hoarser or harsher than usual as stomach acid rises onto your voice box or larynx. Since acid is frequently more prone to flow up the throat when lying down, this symptom could be pronounced in the mornings.

Throat issues- Atypical symptoms can also result from acid reflux into the pharynx or back of the throat. It could seem like you always have a sore throat or need to clear it. Additionally, you can experience a persistent lump in the back of your throat. Other signs include a persistent cough, difficulty swallowing, or frequent hiccups.

The following are potential side effects of acid Reflux on the throat −

Esophagitis − The robust nature of the stomach and esophageal acids irritates the tissues lining the throat.

Constant coughing − Some GERD sufferers need to repeatedly clear their throats, which can cause pain and hoarseness.

Dysphagia − When GERD causes the esophageal lining to scar, swallowing becomes difficult. Pain in the throat and difficulty swallowing can also result from esophageal narrowing (benign esophageal stricture).

Barrett's Esophagus- In addition to sore throat, untreated persistent and severe acid reflux can cause Barrett's esophagus, a rare but deadly illness. It happens when the structure of your esophagus' lining shifts to mirror that of your intestines' lining. Some of the symptoms Barrett's Esophagus shows are coughing, pain in the chest, Dysphagia, pain in the upper abdomen, and heartburn.

Respiratory difficulties- Because acid reflux causes airways to become irritated, people with silent Reflux may wheeze or have trouble breathing. LPR frequently worsens underlying asthma, making treatment more challenging.

Dental decay- The protective enamel of teeth can be worn away or eroded by stomach acid that backs up into the mouth, weakening and discoloring the teeth.

How can one treat Silent Reflux?

Your doctor may request some tests if they suspect you have LPR to confirm the diagnosis and choose the best course of treatment for you. These tests consist of the following steps −

Drinking barium- After the patient consumes a particular barium solution, the upper gastrointestinal system, or digestive tract, is imaged repeatedly using X-ray technology. Doctors can assess the digestive tract for structural issues related to LPR using the contrast solution.

Endoscopy- A small camera and illuminated tube are inserted into the throat by medical professionals. The tube looks for damage consistent with acid reflux in the larynx, pharynx, and esophagus. Typically, tissue samples are collected to be examined in a lab for signs of persistent irritation, inflammation, infection, or abnormal cells.

pH measurement- Through the patient's nose and into the esophagus, the doctor enters a skinny tube. A device at the tube's end monitors the esophageal interior's acidity or pH for one to two days. Alternatively, a capsule is affixed to the esophageal wall to track pH levels. Following the capsule's separation, the patient's digestive system absorbs it. Abnormal levels of acidity suggest LPR in individuals.

Test for proton pump inhibitors- By prescribing the patient a trial of proton pump inhibitors, which lessen the amount of acid released by the stomach, your doctor may attempt to diagnose your issue. You most likely have LPR if taking medicine improves your symptoms or goes away.

Proton pump inhibitors like Nexium (esomeprazole), Protonix (pantoprazole), Prevacid (lansoprazole), Aciphex (rabeprazole), or Prilosec (omeprazole) are most frequently used to treat silent reflux.

Lifestyle changes- Making changes in the lifestyle can also help overcome the problem of silent Reflux. Your physician might suggest the below-mentioned changes −

  • Stop drinking alcohol

  • Do not smoke

  • Shed some weight

  • Avoid caffeine

  • Consume your dinner three hours before sleeping

  • Raising the head 4 to 6 inches during sleeping

  • Wearing loose-fitting clothes

  • Avoiding foods that are fatty, spicy, or fried

Even after making lifestyle modifications and taking medication, LPR symptoms might occasionally recur. Surgery to tighten the lower esophageal sphincter is sometimes the only option.

What can happen if LPR is left untreated?

Patients may develop vocal cord lesions like polyps or granulomas, persistent laryngitis, or asthma if LPR is not treated.

Visit an ENT physician if you or a loved one has any of the symptoms mentioned above. They can complete an evaluation, identify whether you have LPR, and suggest a course of action. The quicker the physician can detect the characteristics of silent Reflux, the quicker the treatment process can begin. Delays will further aggravate the symptoms.


If you are experiencing GERD symptoms, you are not alone. If you believe that acid reflux is the cause of your sore throat, consult your doctor. By controlling your acid reflux symptoms, you can lessen your symptoms and help avoid any difficulties in the future.