At first when you develop Laryngopharyngeal Reflux (LPR) you may only have one symptom that at first could be rather minimal but without knowing it you may get worse over time and you may develop more symptoms that can worsen if you don’t target the problem properly.
The sooner you treat LPR properly, the better the chance for you to heal more quickly and recover. For further information check out my complete LPR guide where I cover LPR causes, symptoms and treatment.
I am often asked what is LPR or what is silent reflux, well if you didn’t already know LPR (Laryngopharyngeal Reflux disease) is caused by acid reflux, more accurately from a stomach enzyme called pepsin. If you didn’t know pepsin is in the stomach to help digest proteins. This reflux goes up the esophagus and into the throat when in a gaseous state. So, when it makes its way up into the throat it can cause inflammation. Usually resulting in LPR symptoms.
There are a host of possible LPR symptoms though it’s less likely you have LPR if you only have 1 symptom for example. If you have 2-3+ symptoms, it’s much more likely your symptoms are related to LPR.
LPR Symptoms / Silent Reflux Symptoms
#1 Sore/Painful Throat
The most common symptom with LPR is a sore or irritated throat. This as you would expect is from the acid coming up into the throat and directly damaging it.
#2 Excess Mucus in Throat
Due to the throat being damaged by the acid you sometimes get an excess build up of mucus in the throat. The body does this because of the inflammation in the throat, its like a sort of self defense to keep the throat lubricated to stop it from drying out and causing more damage. This means more mucus production in the throat.
#3 Chronic Cough
Having a cough is of course another one of the common symptoms of LPR. Sometimes because of excess mucus in the throat you will have the tendency to cough more often.
#4 Throat Clearing
Just like with the chronic cough you may have the need to constantly clear your throat. This is from the excess mucus and the general inflammation of the throat.
#5 Post Nasal Drip
LPR can cause inflammation of the sinuses and as I have mentioned there is excess mucus in the throat because of this. It must go somewhere, and this often means down the throat causing the post nasal drip.
#6 Hard to Swallow
There is a valve in the throat which will typically open when eating and swallowing food. If this valve is damaged or stressed from the acid damage it may not work as it should and this sometimes can lead to problems with swallowing.
#7 Ear pain
Believe it or not LPR can cause ear pain. While this isn’t the most common symptom it can happen. How it happens is from a tube called the eustachian tube which connects the ear to the airways. The gaseous reflux can pass through this tube and give irritation and pain inside the ear. For more information – can acid reflux cause ear pain.
#8 Sore to talk (hoarseness)
As the acid comes up into the throat there will be contact with larynx which is also known as the voice box. The acid that encounters it can damage it. This can lead to hoarseness and pain when talking.
#9 Difficulty breathing
LPR can cause difficulty breathing. The stomach acid comes up and causes inflammation in the airways, this can cause breathing problems.
According to experts determining whether you have asthma or LPR can be understood by your breathing. If you have problems with inhaling (breathing in) it comes from LPR whereas if you have problems exhaling (breathing out) that is typically a sign of an asthmatic. Sometimes LPR can also be called respiratory reflux because of how it can affect your breathing as mentioned.
#10 Lump in throat (Globus sensation)
A lump in the throat feeling is sometimes also referred to as Globus sensation. This is usually caused from inflammation of the throat. You may also have the general tight feeling of the throat or as if something in stuck in the throat.
#11 Excess gas (burping)
Someone who burps more than the average person is more likely to have LPR. The problem with burping is it shows that there is gas coming up. This gas can carry the acid (more importantly pepsin) up into the throat area, which shows the connection between someone who burps too much and someone who has LPR symptoms.
#12 Acidic taste in the mouth
Acid which refluxes up can sometimes make its way all the way up into the mouth. This can give you an acidic taste in the mouth and even pain with your tongue.
How to know if you have LPR (LPR Diagnosis)
A lot of physicians and doctors are not well versed in LPR and often mistreat it as if it were GERD or more typical reflux with symptoms such as heartburn. Sometimes it can be mistaken for even allergies.
If you aren’t sure whether you have LPR or allergies or something else – Luckily there is a test you can do which is a reliable test that can quite accurately determine if you have LPR (silent reflux). The test is called RSI and stands for Reflux Symptom Index. I have created the test, so you can take it right here on my site. Click here to take the RSI test!
Finally, for all causes of LPR, symptoms (helping each symptom) along with LPR treatment check out my Complete LPR guide. Also for additional relief guidance check my article on natural remedies for LPR.
For more help and guidance check my Wipeout Diet Plan and for complete support and treatment consider a Private Acid Reflux Consultation here.
Your articles have been the #1 best on LPR. You have helped me to understand so much more and helped me to treat my daughter that has LPR. Thank you so very much!
Hey Karen, Thank you so much, I am very happy to help.
greeting david thank you for all these advice that you give us to deal with terrible disease, I am suffering from a chronic cough that does not give up I have done a lot of studies, many medications, and visited several doctors including 4 gastroenterologist, and nobody finds anything, they made me a videoendoscopy throat and they reflux and a small nodule caused by the reflux, I plan to buy your diet and follow it step by step I want to cure myself of this so terrible, I just feel cough and it looks like hobby hopefully we can get out of this with the help of God, david thanks for giving us so much information, there is no way to thank you for so much help
Hey Erling,
You are most welcome. I am glad to be able to offer my advice and help when I can. Yes I think the diet is a great thing that can make a massive difference!
What can we do to stop the burping? I am eating small meals of bland non-acidic foods for a week now to try to control LPR but the diet doesn’t seem to stop burping. In fact, I never really had a burping issue before this. I realize that the proton pump inhibitors the doc gave me aren’t going to help but I thought I would take them just for the first two weeks while I’m adjusting my diet and then quit them. I am one week in. Possibly they are causing the gas? Don’t know. Or possibly it’s all the whole grains and vegi’s (tons of fiber) I’m eating now. I cannot even get enough calories in before I have to quit eating at 7pm. Then I got my stomach growling for food at 10pm, but can’t eat, and waking up hungry in the night. But I’m doing every thing I can diet wise to prevent acid & pepsin from coming up, but if the diet doesn’t control the gas bringing it up, then I will never heal. What’s the fix for the burping I wonder? Even water makes me burp first thing in the morning and I haven’t even eaten in hours?
Yes you are probably on the right train of thought. It could be either the PPIs or too much fiber. I know for myself and some people if I eat too much fiber like lots of nuts I burp quite a lot more and this would worsen my symptoms when I do it consistently. Try lowering your high fiber foods and consider about lowering or coming off the PPIs too.
For the past couple of months, I’ve been experiencing some regurgitation of foods or liquids, a lot of post nasal drip and a burning tongue. Does this sound like LPR?
It definitely could be yes. The nasal drip and burning tongue both point to that in particular.
Hello David, firstly thank you so much for educating us on this, I knew nothing about silent acid reflux until now which I think I may have?
I have had sinus problems for as long as I can remember, congestion, feeling bunged up, dust allergy, sores in the nostrils…
I have had issues with bloating and flatulence for a long time, mainly after eating.
My main issue I am suffering with right now which has led me to you is this really painful throat, neck and earache which I have had every day for 4 weeks.
I took your test and scored 22. Constantly having to clear my throat, post nasal drip, my voice has sounded hoarse for longer than I’ve been dealing with this throat problem. I also have burning sensations on the lips, in the mouth and throat at times.
I’m hoping i have finally discovered what this throat issue is because it is really draining me out and I’m stressing it could be something more serious.
I wanted to ask, can silent reflux cause throat ulcers? As I also have one / two at the back of my throat along with some other things including white tongue…
I look forward to hearing back from you.
Hey Chan,
You are welcome. Yes sounds definitely like LPR to me. I think it can make ulcers more likely especially if it drys your mouth and throat out.
Hi David,
I’m David myself. This has been a very informative page I have to admit, thank you very much. I’ve been having the below symptoms closing in on a year.
Globus sensation and feeling of burps getting stuck in the throat, feeling of acid in mouth rarely but redish uvula. I’ve never felt any pain at all and whent to my doctor explaining the above with the addition of when I sneez,(globus sensation) temporarily goes away. Which he diagnosed as throat infection. I got antibiotics and this temporarily alliviated but returned quickly. At first I thought gerd but as have no pain, from research appears as to be lpr. I did smoke, have now been on off for a year currently off them but like my coffee. At this stage should I be seeking a endoscopy? Many thanks for your attention on the matter.
Hi David,
Thank you very much. It definitely sounds like LPR from what you mentioned. Instead of seeking an endoscopy consider making diet changes firstly eliminating the common trigger foods and drinks. As you have mentioned coffee and smoking, it would be wise to stop both of them as an example.
Hi David – I learned so very much from you. Thank-you very much. I am most probably going to try your diet. I am having a tough time right now with so many of the symptoms. I have to take an 81 aspirin every day and I’m wondering if even with the diet I will still have issues. I’m hoping not and want so much to have some relief. Has anyone ever asked about aspirin and LPR? I didn’t even know LPR existed until I found your site. The way I was eating was very bad and I’ve struggled with so many of these symptoms for years. Thank-you again!!!
Hi Grace,
Always help to be of help. I have had some people ask if aspirin can affect or upset the stomach. The answer is yes it can. Actually it can and sometimes dose upset and generally cause problem with the stomach and the whole digestive system. I would definitely suggest not taking much if any if at all possible. If you must take it, of course I highly recommend to take it with a meaningful meal and keep the dose lower if you can.
Hi David,
I am suffering from burping issues since 2 months. For once in Feb & March I had gas issues and we soon gone with in 3-4 days of Nexium. But in March doctor found out that I have nasal congestion. Due to lockdown issues I wasn’t treated soon. Now after taking CT scan ENT found out that I have sinusitis with inflammation. I am being treated with antibiotics and methylprednisolone. I have been taking Nexium twice a day since 3 weeks. If I stop even for 1 time a day, my stomach will become hard and have to burp. Until I burp I feel so uncomfortable.
Now I have a doubt if my problem is due to LPR. My first symptom is burping or gas issue. Didn’t have any sinusitis symptoms in the beginning or even now. Just mucus in throat and severe burping. Please help me with my situation.
Not sure if my antibiotics will clear the issue( using them since 4 days). If this problem is due to lpr please refer me something that will help me. Had several sleepless nights because of this issue since 2 months.
Thanks in advance. Your reply will mean a lot.
If you have a lot of gas that is likely correlated to the LPR, trying to stop that will likely help or lessen your LPR symptoms. I would guess the anti-biotics actually made things worse in this case. The sinus inflammation is likely due to LPR, spraying the nose with an alkaline solution made with alkaline water and baking soda would likely help along with diet changes.
Hi very interesting information as I have been diagnosed with silent reflux but the chronic hours of coughing, vomiting due to the coughing, does throat and losing my voice daily are taking a toll. I also get mild earache. It’s been going on for 7+ weeks and I’m tired through lack of sleep and pain in my throat. Hoping there is something other than alprazolam i can be given. Dietary changes and increased exercise are enjoyable but not really doing much and I don’t drink or smoke. It’s frustrating.
Hi Donna,
Definitely look into a low acid diet like my wipeout diet and also medication like Gaviscon Advance (UK) to be taken after meals and at bedtime.
I just have burning in throat, was drinking ACV and thought it would help but it got worst. I stop and take baking soda I gargle, can I drink it as well and how much.
I take HCL and probiotics Enzymes. I am glad you said no ACV feeling much better, otherwise I have good diet. Any other suggestions. Thanks
Yeah ACV is not a good choice for people with LPR really. If you are taking HCL be aware that could make things worse depending on your root cause. I would consider that in your case as well as the enzymes. Diet is most important, definitely consider all aspects of your diet, as even 1 or 2 small mistakes can hold back healing!
Please can you tell me if lpr can cause dry mouth and if so how, everything I’ve read seems to indicate the opposite and you hyper salivate. Ent scoped and said LPR but I don’t know if that could have caused the dry mouth or the dry mouth and gum chewing to combat the dryness caused the lpr.
Also if I take gaviscon at night I have so much more reflux symptoms the next day with stomach pain and acid taste
Yes it can, the pepsin can make the throat and mouth more dry. This can also damage the functions that develop salvia in the mouth too. It’s definitely the LPR causing it I would say. I have the exact same dry mouth too.
That’s interesting the Gaviscon seemingly makes it worse. Perhaps it could be related to low stomach acid due to that fact and may be worth looking into more in your case.
So has your dry mouth not gone from treating lpr? Im also experiencing dry eyes so have been tested for Sjorgens but also read 1 study that acid can get into your eyes. My sjorgens testing comes back negative but I know having a lack of saliva can cause acid reflux. I was hoping by treating lpr I might get some saliva back.
I still get an occasional dry mouth, it is one of my remaining symptoms. Yeah I have heard some people saying it bothered there eyes, I would be interested to see that study you mentioned if you can send it over.
Hi Charlotte,
I developed dry eyes, mouth, sinus and ears from LPR.
Have you gotten better?
Hi David, I hope this reaches you. I have had a sore throat for last 3.5 weeks that moves from one side to the other to even both. I thought it had gone about 10 days ago but has come back again. I have now been referred to an ENT for urgent review (my request) I think I have had mild post nasal drip for 4 years but never had a sore throat, except once last year that went quickly. I want to find out what it is but am worried about not treating it (if that’s what I have had for years) and what damage I may have done to my throat as a result. I have only had 2 episodes and perhaps a couple of slight hoarseness episodes. What do you think? Any advice would be appreciated. Thanks Steve
Hi Steve, the couple of symptoms you mentioned of course are related to LPR but I would need more information on them to be able to say if it’s more likely or not. If it is LPR diet a low acid and natural diet should be your first form of action. Send me an email – david@wipeoutreflux.com and I’ll give you more information.