Laryngopharyngeal (Silent) Reflux

What is it?
Silent reflux, also known as laryngopharyngeal reflux, is a condition where acid and/or non-acid products travel from the stomach, up the esophagus, and onto the larynx.  This can cause swelling and redness of the voice box leading to raspiness, chronic cough, feeling like something is stuck in the throat (globus sensation), and/or frequent throat clearing.  Interestingly, patients often have these “laryngeal” symptoms without “esophageal” symptoms of acid reflux (i.e. burning in the chest after meals).

How is it treated?
Silent reflux is initially treated with lifestyle modifications, such as dietary changes.  Patients may be initiated on acid-lowering medications as well.  Patients may undergo in-office evaluation of the esophagus (trans-nasal esophagoscopy) or special testing of acid levels to help guide therapy.  Ultimately, patients with persistent symptoms and evidence of reflux on examinations may require further evaluation by other specialists as well.