What is Silent Acid Reflux?

Silent acid reflux is a medical condition caused by weakening of the sphincters designed to keep stomach acid out of the esophagus and throat. The stomach acid enters the throat and voicebox, causing irritation and leading to symptoms like wheezing and hoarseness. People refer to this condition as “silent” acid reflux because it does not cause heartburn, the uncomfortable sensation associated with chronic irritation of the esophagus. Silent acid reflux is usually diagnosed by a specialist and there are treatments available to help patients manage it, although it can be stubborn and challenging to treat.

Also known as laryngopharyngeal reflux, silent acid reflux is closely related to gastroesophageal reflux disease (GERD). Both conditions involve weakening of the esophageal sphincters. In the case of silent acid reflux, the lower and upper sphincters both weaken, allowing stomach acid to reach the throat. The tissues in the throat are very sensitive to stomach acid and respond with inflammation and irritation.

People with laryngopharyngeal reflux tend not to experience heartburn because the acid doesn't linger in the esophagus long enough to irritate it, and the hardier tissues in the esophagus don't develop painful inflammation. Patients can experience symptoms like sleep disorders, coughing, indigestion, wheezing, hoarseness, and trouble speaking as a result of the damage caused by the stomach acid. The absence of heartburn sometimes makes silent acid reflux hard to diagnose, as a doctor may not immediately realize that stomach acid is the source of the problem.

Examination with an endoscopy is usually needed for successful diagnosis of patients with this disease. In this procedure, a camera will be fed into the throat and esophagus to examine them for signs of inflammation and irritation. Other diagnostic tests may be used as well to rule out any diagnoses a doctor may be considering in addition to silent acid reflux.

One of the best treatments for this condition is surgery to address the weakened lower esophageal sphincter. The surgery will keep stomach acid out of the esophagus and throat and make the patient feel more comfortable. Dietary controls and medications can also be used in the management of this condition. Patients may find it helpful to meet with several physicians to learn about all their treatment options and to take advantage of specialist knowledge. Specialists often know about the latest treatment options, including clinical trials, and can help patients make an informed choice about appropriate treatments.