When most people hear the word GERD, they think of heartburn — that burning sensation that creeps up after a heavy meal or late-night snack. But what if you had reflux… with no burning at all?
That’s where silent reflux comes in — a tricky, often overlooked condition that doesn’t cause heartburn, yet quietly irritates your throat, affects your voice, and can leave you coughing for weeks. So, what exactly is silent reflux, and how can you tell if it’s happening to you?
Let’s break it down.
What Is Silent Reflux (LPR) and How Is It Different from GERD?
Silent reflux, or laryngopharyngeal reflux (LPR), is a close cousin of GERD — but with a twist. Instead of acid just rising into the esophagus (like in GERD), it goes even higher, reaching your throat and voice box.
And here’s the kicker: it often doesn’t cause heartburn.
That’s why it’s called “silent.” It sneaks in under the radar, showing up as:
- A hoarse voice, especially in the morning
- Frequent throat clearing
- A sensation of a lump in your throat
- A dry cough that just won’t quit
- Bitter taste or sore throat, especially when you wake up
While GERD is more about chest burn, silent reflux is more about throat irritation. Many people don’t realise they have it until symptoms linger for weeks or even months.
Chronic Cough and Throat Clearing: Could It Be Silent Reflux?
Have you been coughing for weeks, even though you’re not sick?
Do you find yourself constantly clearing your throat — especially after talking or eating?
Many assume this is due to allergies, asthma, or post-nasal drip. But in reality, LPR is one of the most under-recognised causes of chronic cough.
The backflow of acid irritates the throat and vocal cords. Unlike your esophagus, your throat is much more sensitive — even small amounts of acid can set off a chain reaction of inflammation, coughing, and that annoying need to clear your throat.
Here’s a tip: If your cough doesn’t improve with antihistamines or inhalers, silent reflux might be the real culprit.
Foods That Worsen Silent Reflux Without You Realising
Think you’re eating healthy but still feeling throat irritation or a scratchy voice?
Sometimes the problem isn’t how much you eat — but what you eat.
Here are common silent reflux trigger foods:
- Coffee (yes, even decaf!)
- Chocolate
- Tomatoes and anything tomato-based
- Citrus fruits (like oranges and lemons)
- Fatty or fried foods
- Alcohol
- Peppermint and spearmint
- Fizzy drinks (like soda or sparkling water)
Even some so-called “healthy” foods like yoghurt or fruit juice can trigger symptoms. It really depends on your personal sensitivity.
Keeping a food diary can help spot patterns. If you notice your symptoms flaring up after certain meals, consider removing that item for a while and observe what happens.
Sleeping Positions That Can Help with Silent Reflux
How you sleep at night can make a surprising difference in your symptoms.
Why? Because when you lie down, gravity no longer helps keep stomach contents where they belong. For people with silent reflux, that means acid can more easily creep up into the throat.
Here are a few simple sleep tips:
- Sleep on your left side – it keeps the stomach below the esophagus, reducing reflux.
- Avoid lying down right after meals – wait at least 2-3 hours after eating before heading to bed.
- Raise the head of your bed by about 15–20 cm. Use blocks or a wedge pillow – stacking pillows under your head won’t help much and may strain your neck.
Small changes like these can mean a smoother, more peaceful sleep — and fewer throat symptoms in the morning.
Do Antacids Work for Silent Reflux?
You might be wondering, “Can I just pop an antacid and be done with it?”
Well, yes and no.
Antacids, like Gaviscon or TUMS, can offer short-term relief by neutralising acid. But they don’t last long. If you’re dealing with ongoing silent reflux, doctors often recommend proton pump inhibitors (PPIs) like omeprazole or H2 blockers like ranitidine (though some of these have been phased out due to safety concerns).
That said, medication alone isn’t enough for silent reflux. Because LPR often involves pepsin — a digestive enzyme that sticks around and causes damage even after the acid is gone — lifestyle and dietary changes are just as important as pills.
Silent Reflux or Asthma? How to Tell the Difference
This one trips a lot of people up.
You’re wheezing, coughing, short of breath… asthma, right? Not always.
Silent reflux can mimic asthma, and sometimes co-exists with it. In fact, some patients who don’t respond well to asthma treatment actually have underlying LPR.
Here are a few signs it might be reflux instead of asthma:
- You cough more after eating or lying down
- Asthma medications don’t seem to help much
- You have no clear allergic triggers
- You also notice voice changes or a sour taste
If this sounds familiar, speak to your doctor — they may refer you to an ENT or suggest a pH test to confirm silent reflux.
Final Thoughts
Silent reflux doesn’t come with flashing warning signs. No fiery heartburn, no dramatic symptoms. But it quietly chips away at your throat health, voice, and comfort — sometimes for months before you even suspect what’s going on.
The good news? Once identified, it’s manageable.
Through smart food choices, better sleep habits, and the right treatment plan, most people can find relief. The key is knowing what to look for — and not ignoring that nagging cough or hoarse voice that just won’t go away.
So… could your symptoms be more than just a cold or allergies? Don’t let silent reflux sneak past you.
References
- Laryngopharyngeal Reflux: Diagnosis and Treatment – American Academy of Otolaryngology–Head and Neck Surgery, 2020. https://www.entnet.org/resource/laryngopharyngeal-reflux/
- Chronic Cough Due to Gastroesophageal Reflux in Adults – Chest Journal, American College of Chest Physicians, 2006. https://journal.chestnet.org/article/S0012-3692(15)32585-9/fulltext
- Reflux Diet – UNC School of Medicine Center for Esophageal Diseases and Swallowing, 2019. https://www.med.unc.edu/ent/files/2020/05/reflux-diet.pdf
- Gastroesophageal Reflux and Sleep: Physiology and Pathophysiology – Chest Journal, 2005. https://journal.chestnet.org/article/S0012-3692(15)47150-9/fulltext