Silent reflux, also called laryngopharyngeal reflux (LPR), happens when stomach contents travel upward through the esophagus (food tube) and irritate the throat and voice box.
Unlike typical acid reflux, silent reflux does not always cause heartburn.
Common symptoms
- Hoarseness or other voice changes
- Frequent throat clearing
- Excess throat mucus or a feeling of postnasal drainage
- A feeling of something stuck or a lump in the throat
- Intermittent difficulty swallowing food, liquids, or pills
- Coughing after eating or when lying down
- Persistent or troublesome cough
- Episodes of choking or difficulty breathing
- Heartburn, indigestion, chest discomfort, or stomach contents coming back up
Not everyone with silent reflux has heartburn.
Lifestyle changes
Simple changes are often an important part of treatment:
- Avoid eating for about 3 hours before bedtime.
- Try smaller meals, especially in the evening.
- Reduce foods or drinks that clearly trigger your symptoms rather than avoiding everything unnecessarily.
- Common triggers may include very fatty meals, spicy foods, chocolate, caffeine, carbonated drinks, and acidic foods.
- Limit smoking and vaping.
- If symptoms are worse at night, raising the head of the bed may help.
- Weight reduction may help when excess weight is contributing to reflux.
Alginate treatment
An alginate such as Gaviscon forms a physical barrier that helps reduce reflux reaching the throat. Alginates are derived from seaweed and work mainly by a mechanical rather than acid-suppressing effect.
Alginates are generally well tolerated and may be used longer term when appropriate. Gaviscon can be used during pregnancy.
Take after meals regularly for at least one month. If symptoms improve, you can then reduce how often you use it and take it when needed.
How long does improvement take?
Throat symptoms may improve more slowly than typical heartburn. Improvement may take several weeks even when treatment is working.
When should you be assessed?
Arrange medical assessment if symptoms are persistent, worsening, or associated with:
- Persistent difficulty or pain with swallowing
- Unexplained weight loss
- Persistent hoarseness
- Coughing or choking when swallowing
- Blood in the saliva or vomit
- A neck lump
Important: These symptoms are not specific to silent reflux and can occur with other conditions. This page provides general information and is not a diagnosis. Persistent, worsening, or concerning symptoms should be assessed by a healthcare professional.