Jan 22, 2013
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Silent Reflux – Reflux In Adults

Silent reflux also known as Laryngealpharyngeal reflux or LPR is a form of Gastroesophageal reflux disease or GERD.

GERD is a very common disorder and this is when the foods and acids in the stomach come back up into the esophagus.

This heartburn can happen to anyone at any stage in their lives and can usually be treated with over the counter medication or prescribed medicines.

But for some people the food and acid can come right up into the back of the throat and voice box which is okay on the odd occasion but if it happens regularly it is called Laryngeal-Pharyngeal Reflux or LPR which can lead to serious problems if left untreated.

It is caused by the dysfunction of the lower and upper oesophageal sphincter muscles. In some cases many people do not have symptoms of heartburn and this is why it is called silent reflux. And because of this it can be undiagnosed or miss diagnosed.

The problems associated with Laryngealpharyngeal reflux are very different from GERD these can include:

• Recurrent hoarseness
• Frequent coughing spells
• Adult asthma
• Sore throats that are hard to cure
• Sinus problems
• Excessive mucus in your throat
• Feeling a lump in your throat
• Burning sensation in the throat

You see acids that pass quickly through the esophagus does not have a chance to irritate that area and this is why patients quite often don’t appear to have symptoms of heartburn. However acid that pools in the back of the throat and voice box will cause prolonged irritation which will result in the symptoms of silent reflux.

To determine if you have LPR a Laryngoscopy can be done.

A Laryngoscopy examination will let your doctor examine the back of your throat and surrounding areas without sedation. If the area is red and inflamed you may have LPR.

Treatment for LPR is a combination of lifestyle changes as well as medications and LPR should not be ignored as it can turn into something more serious – cancer.

Lifestyle changes that can help reduce or eliminate Silent Reflux are:

• Stop smoking – smoking will reduce the tone of the muscle of the lower oesophageal sphincter.
• Avoid tight fitting clothing as this can cause pressure on the stomach and this in turn can cause reflux.
• Elevate the head of your bed at least 6 inches this will help stop the acid coming back up into your throat when laying down.
• Don’t eat too late. Stop eating at least 3 hours before going to bed, you are better of going to bed on an empty stomach.
• Lose weight for some even just losing a few pounds will stop acid reflux.
• Avoid certain drinks such as caffeine, carbonated and alcohol especially late at night.
• Avoid certain foods such as chesses, fried , citrus, red sauce and chocolate.

Medications such as Proton Pump Inhibitors and H2 Blockers these are medications such as Prilosec OTC and Zantac can help in reducing the acid reflux.

In cases where medication and lifestyle changes do not help LPR then surgery may be the best option.

Surgery is a last resort and this is only for the people where medication and lifestyle modifications make no difference in reducing acid reflux. Surgery is then recommended to tighten the lower esophageal sphincter muscle.

The operation for LPR is called Nissen Fundoplication it was developed by Dr Nissen who originally developed with operation.

What happens in the operation – a valve is created using the floppy upper portion of the stomach and it is then folded around the end of the esophagus (the tube that allows your food to enter the stomach). This new valve will help stop the food and acids from coming back up into the esophagus.

After the operation most patients will see results within two weeks. However it is recommended that they take medication for at least two months after surgery after which the medication can be tapered off, as well as keeping up the lifestyle changes.