Silent Reflux

November 2nd, 2016 by admin in Throat Clinic, Voice Clinic Comments Off on Silent Reflux

Silent Reflux is a very common, primarily asymptomatic condition in which gastric contents move back up the aerodigestive tract, into the oesophagus, pharynx, larynx, oral cavity and the nasopharynx. Reports suggest 10% of otolaryngology referrals are for patients with classic presentation of silent reflux and the 50 to 60% of cases of chronic laryngitis are related to the condition.

Most patients with silent reflux do not experience heartburn or have esophagitis. Interestingly, to have significant symptoms such as chronic cough or a sore throat you only need to have one episode of refluxate in the upper aerodigestive tract in a 24-hour period. Hence many of these patients are unaware of having reflux.

Treatment protocol focuses on acid suppression with proton pump inhibitors, in addition to diet and lifestyle modification.

PPIs should be taken twice daily for 4-6 months on an empty stomach, 30 minutes before a meal to increase bioavailability. Symptomatic relief may begin at 6-8 weeks of treatment however patients should gradually be weaned off the drug to prevent delayed rebound effects associated with abrupt cessation.

Diet and lifestyle modification is both clinically and cost effective. These modifications include not drinking for 2-3 hours before bed, elevating the head of the bed, and avoiding smoking.

If you have been experiencing unexplained hoarseness or laryngitis, please get a referral letter from your local doctor and contact Havas ENT Clinics on 02 9387 7360 and Professor Havas can ascertain whether silent reflux is the cause of your symptoms.

For more information about laryngopharyngeal reflux and silent reflux, please check our Reflux page.