Silent Reflux (Laryngopharyngeal Reflux)

New Patient Appointment or 214-645-8300

UT Southwestern Medical Center’s experts in throat and digestive tract conditions have advanced training and extensive experience in treating silent reflux – also known as laryngopharyngeal reflux (LPR) – and related disorders.

Our teams use the latest advancements to relieve symptoms and treat the causes of LPR, providing the best possible outcomes for patients.

Why Choose UT Southwestern for Silent Reflux Care?

Laryngopharyngeal reflux is a condition in which stomach contents flow back up the esophagus (swallowing tube) and into the larynx (voice box) and throat. LPR is also called extra-esophageal reflux, as it causes throat symptoms. Sometimes, LPR just causes throat symptoms in isolation without the classic heartburn and regurgitation seen in gastroesophageal reflux disease (GERD).

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 treatment with medications and lifestyle changes. We might recommend advanced minimally invasive procedures for patients who do not respond to nonsurgical treatment.

What Causes 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 and up to the throat and larynx.

Risk factors for developing LPR include:

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

What Are Symptoms of Silent Reflux?

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

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

How Is Silent Reflux Diagnosed?

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 will diagnose reflux with objective testing, such as pH and impedance testing.

When needed, additional tests might include:

Acid reflux test: Test to measure the amount of acid in the fluid inside the esophagus
Upper endoscopy or esophagogastroduodenoscopy (EGD): Test to view inside the throat and esophagus using a long tube with a lighted camera at its tip
Barium swallow 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

How Is Silent Reflux Treated?

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 receptor blockers
Alginate therapy

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

Losing weight
Avoiding acid-producing foods such as chocolate, fried foods, citrus fruits, spicy foods, and tomato-based products
Stopping eating at least three to four hours before bedtime
Elevating the head during sleep to at least 30 degrees

In some cases, when medical management and lifestyle changes do not improve a patient’s symptoms, they are referred to our foregut surgeons for consideration of minimally invasive anti-reflux surgery.