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A Closer Look At Silent Acid Reflux + How To Know If You Have It

Jonathan Aviv, M.D., FACS
Doctor of Medicine By Jonathan Aviv, M.D., FACS
Doctor of Medicine
Jonathan E. Aviv, M.D., FACS, is the Clinical Director of the Voice and Swallowing Center for ENT and Allergy Associates in New York, Clinical Professor of Otolaryngology for the Icahn School of Medicine at Mount Sinai, and author of The Acid Watcher Diet: A 28-Day Reflux Prevention and Healing Program (2017). He received his doctor of medicine degree from Columbia University.
5 Signs You Have Acid Reflux & Don't Know It

Heartburn or acid indigestion is one of the most common digestive complaints out there, with 60 million Americans experiencing it at least once a month. If you've had heartburn, you likely know exactly how it feels. But in case you haven't, it's described as the burning (often searing) sensation one experiences in the mid-chest area and is typically associated with eating certain foods or beverages.

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These trigger foods—like coffee, alcohol, mint, and chocolate—cause acid from the stomach to reverse flow or reflux, back up into the esophagus (the tube connecting the throat to the stomach), which causes chest burning and pain. But many people don't know that heartburn is just one of the symptoms of acid reflux, and because it's often the loudest, we often substitute the medical diagnostic term "acid reflux" for the symptom "heartburn." But reflux can cause symptoms far beyond this...


What is silent reflux and how do I know if I have it?

You may have already heard of the term "silent acid reflux," which describes the nontraditional symptoms of reflux disease that often go undiagnosed, misdiagnosed, or simply unnoticed. They include chronic cough, hoarseness, frequent throat clearing, a lump-like sensation in the throat, and postnasal drip. Thanks to the constant coughing and loud throat-clearing that reflux sufferers often face, "silent" acid reflux is actually anything but. I prefer using the term "throatburn" reflux—acid reflux disease without the traditional symptom of heartburn.

What causes throatburn reflux?

These throat and nose symptoms aren't usually connected with acid reflux because their source is anatomically quite a distance away from the gut. But the root cause of either the cough, change in voice, thick mucus in the throat, difficulty swallowing, or nasal symptoms is the same: The corresponding tissues are swollen and irritated due to stomach acid refluxing all the way back up into your nose. This type of reflux is also usually caused by certain foods, which create a path of irritation beginning in the mouth that spreads to the throat, vocal cords, lungs, and esophagus. And when the lungs, vocal cords, throat, top of the esophagus, and nasal and sinus tissues swell, they each produce the respective symptoms you—and all those around you—hear.


Do I have any natural treatment options?

You can help treat these symptoms by cutting very acidic foods out of your diet, such as sugary soda (including diet soda), bottled ice tea, citrus, tomato, vinegar, and wine. For complete dietary guidelines, here's an article on exactly what to eat (and avoid) when you have acid reflux.

Unfortunately, the popular response when someone relates the common throatburn symptoms is, "Yeah it's so annoying, but don't worry, just take an antihistamine and you'll feel better in the morning." This could end up being a dangerous approach. Typically, you won't feel better after taking over-the-counter meds, as you would for a cold or allergy. More importantly, this group of nose and throat complaints can herald serious inflammation or disease in your stomach and esophagus. The most worrisome of these conditions can even be esophageal pre-cancer. So when you notice throatburn reflux symptoms—especially for more than two weeks—please see your doctor and have the source identified!


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