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Hoarse Voice? Silent Reflux May Be the Cause

January 03, 2024

Have you lost your voice? Or do you feel like you need to clear your throat often? Before you reach for the cold medicine, you may want to talk to your doctor about silent reflux. “Silent reflux is a disease state where the patient doesn't complain of typical acid reflux symptoms like heartburn, burning in the upper stomach or the lower esophagus,” says Housein M. Wazaz, MD, a gastroenterologist at MidState Medical Center. Like the name suggests, silent reflux symptoms can be subtle. So, how do you know you have it? Dr. Wazaz helps break it down for us, including why (and how) to treat it. [insert-cta-small id=53152]

It may seem more like a cold than a digestive issue.

With silent reflux, the contents of your stomach can travel up to your esophagus, into your throat and voice box, or nasal passages. While symptoms may not be immediate, this damage can soon present as symptoms, including:
  • Feeling like you have a lump in your throat (“globus sensation”)
  • Lost voice/hoarseness like you’ve been singing all night
  • Burning sensation in the throat
  • A frequent urge to clear your throat
  • Earache
  • Sinus issues, notably chronic postnasal drip
“There are shades of silent reflux,” says Dr. Wazaz. “Some people have severe silent reflux where their voices are always scratchy. And then some people have it on and off. Most of their symptoms are episodic and usually triggered after eating heavy meals or drinking late at night.” You're also more likely to experience symptoms at night when you're laying down. “Silent reflux mostly happens at night when the acid can end up your throat,” explains Dr. Wazaz. “You will likely experience it less when you’re standing upright, and the acids can’t reach your esophagus.” > Related: 4 Home Remedies for Heartburn That Actually Work

When to see a doctor.

If you think you have silent reflux, you should speak with your primary care provider. “With chronic throat symptoms, you often rule out many things like pharyngitis, seasonal allergies, and postnasal drip before this comes into the picture,” explains Dr. Wazaz. “You need to have a clinical suspicion and understanding of silent reflux to diagnose it.” Your doctor may refer you to a gastroenterologist who can provide a complete examination. They also may perform an endoscopy or recommend a test to measure the acidity in your esophagus. Want more health news? Text StartHere to 85209 to sign up for text alerts

3 ways to treat silent reflux at home.

Dr. Wazaz first recommends three lifestyle modification changes:
  1. Don’t eat three hours before bedtime. It’s not just what you eat, either. It’s when and how much you eat.
  2. Lose weight if obesity is putting too much pressure on your stomach.
  3. Sleep a little elevated in your bed.
Medical therapy also plays a big role. Your doctor will discuss whether H2 blockers, proton pump inhibitors or a combination of both may be best for you. “When we treat people with silent reflux, it can take weeks, or sometimes months, for this to go away,” says Dr. Wazaz. “With typical acid reflux, medication can make you feel better in days or even hours. But silent reflux involves a chemical injury to the throat, which usually takes a long time to heal.”

Treatment works, but it can take some time.

People with silent reflux can expect to feel better in about six to eight weeks. “This is not taking medicine only when you have heartburn. It doesn’t work like that,” says Dr. Wazaz. You need to be compliant with your treatment plan every day to heal the esophagus. It won’t happen overnight but don’t give up. Stick with the plan.” If your symptoms get worse or you have trouble swallowing, Dr. Wazaz encourages you to see your gastroenterologist for a comprehensive workup and care plan.