There's a type of reflux which is atypical and "silent" because it doesn't create the typical symptoms of acid reflux. It's LRP - laryngopharyngeal reflux. Your larynx is your voice box, and your pharynx is your throat.

This condition is frequently misdiagnosed as allergies, infections (like chronic sinusitis), vocal strain, or even anxiety-related throat tension, when it's actually a form of acid reflux. And endoscopies are frequently normal so going through that test is no help in identifying this problem unless your concurrently have classic acid reflux.

It can be very frustrating living with these symptoms and your doctor missing the real cause.

The interesting question is how acid reflux can pass through your esophagus and not create classic symptoms. There are a few different thoughts on how this occurs. Firstly this type of reflux is brief and occurs when the individual is upright vs lying down as is so common with classic acid reflux.

The acid doesn't "pool" or reside in the esophagus for long, going right up past the sphincter (valve) situated at the top of the esophagus to create its symptoms. This valve is called the UES - upper esophageal sphincter. 

Due to the acid moving past the esophagus into the voice box and throat, it's not surprising that the symptoms associated with LPR are as follows:
chronic cough
hoarseness
throat clearing
post nasal drip
lump in throat
difficulty swallowing
sore throat

The causes are considered to be:
A weak UES - upper esophageal sphincter. The vagus nerve irritation can cause this and we frequently discuss the interrelationship between hiatal hernia and vagus nerve tone being abnormal.

Increased intra-abdominal pressure - the cause I always discuss as the reason underlying hiatal hernia syndrome. The key is to identify the root cause of what's creating it.

Diet and lifestyle - the typical "bad guys" we discuss including sugar, refined carbohydrates, ultra-processed foods, alcohol, sedentary lifestyle, stress, etc.

Vagus nerve irritation - it affects not just the sphincters, but how the stomach, diaphragm and heart function.

Gastroparesis - a slowing of the stomach to empty its contents into the small intestine. This can be caused by certain medications, infections, diabetes and more.

Smoking and excess Alcohol

LPR can later become class acid reflux, or as mentioned above, both can occur at the same time. 

The Root Cause Medicine approach is to truly identify the root cause of why the reflux is occurring rather than "band-aiding" symptoms with medications. We look at diet, gut health, vagus nerve function, inflammation, and more. 

Much can be done to eliminate reflux from happening when the true root cause(s) are identified. And the good news is that the treatment is a natural one - no drugs or surgery.

If you're suffering with these symptoms we'd be delighted to help. Contact us for a consultation and we'll determine if what we do is a good fit for you. Call 727-335-0400.

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