Reflux Isn’t Always Heartburn: Understanding Classic and Silent Reflux

When we think of reflux, we usually imagine burning in the chest — classic heartburn that rises after a meal or when lying down. But not all reflux looks like this.

Laryngopharyngeal reflux (LPR), also known as silent reflux, affects the throat and upper airways rather than the oesophagus. And because it doesn’t cause the typical burning sensation, it’s often missed — or misdiagnosed.

What Is Silent Reflux?

Silent reflux occurs when stomach contents travel past the oesophagus and into the throat or larynx. The tissues here are much more sensitive to acid and enzymes, so even small amounts can cause significant irritation. Symptoms might include:

• Constant throat clearing

• A persistent cough

• A hoarse or fatigued voice

• Sore throat, especially in the morning

• A lump-in-throat sensation

• Burning or pain higher in the chest or throat

These symptoms can easily be mistaken for allergies, post-nasal drip, or even anxiety-related throat tension.

Why Standard Treatments Don’t Always Help

Proton pump inhibitors (PPIs) are commonly prescribed to reduce stomach acid. While they can be helpful for classic reflux, they don’t always work for LPR. That’s because silent reflux is often more about dysfunction in the oesophageal sphincters, poor clearance, or delayed gastric emptying — not just excess acid production.

This can leave people feeling frustrated and unsupported — especially when symptoms linger or return after stopping medication.

How to Support Reflux Holistically

Supporting reflux — especially silent reflux — requires a personalised, functional approach. Here are some foundations to consider:

1. Eat in a way that supports digestion: chew thoroughly, eat slowly, and avoid lying down after meals.

2. Identify and reduce your trigger foods (common ones include citrus, spicy foods, caffeine, and chocolate).

3. Soothe the throat and airways with herbal teas, steam, and gentle voice care.

4. Support stomach function and motility through movement, upright posture, and nervous system regulation.

5. Manage stress — as gut-brain signalling can worsen reflux symptoms and slow digestion.

It’s not just about avoiding certain foods — it’s about improving the function of your digestive system and reducing irritation where it counts most.

You’re not imagining your symptoms, and you don’t have to live with them long-term. There are practical, gentle strategies that can help bring lasting relief — even when PPIs fall short.

Want tailored support for reflux or silent reflux?You can book a 1:1 consult through my website, or read more in the reflux carousel series on Instagram.