GERD: The Silent GERD Symptoms

In some cases of esophageal damage due to a malfunctioning LES, the patient does not experience heartburn - this is known as silent GERD symptoms or laryngopharyngeal reflux (LPR). LPR is just as dangerous as GERD, if not more dangerous due to the lack of obvious symptoms. Learning what symptoms do occur in cases of LPR is important to avoiding serious damage to the esophagus and the development of serious conditions.

While a large percentage of the population of the United States has experienced heartburn, or acid reflux, at some time or another, a considerable number of people experience acid reflux almost every day. Chronic heartburn is a sign of gastroesophageal reflux disease, or GERD.

GERD is present when the lower esophageal sphincter doesn’t function properly, and stomach acid is allowed to travel into the esophagus. Most symptoms, except for heartburn, are a result of mucus produced to protect delicate tissues from the acid. In the long term, serious damage is done to the esophageal tissues and more dangerous conditions are more likely to develop.

Symptoms of Laryngopharyngeal Reflux

GERD sufferers experience a wide variety of symptoms, ranging from cold-like or asthmas-like symptoms to back pain. The same is true of sufferers of LPR, however LPR symptoms are usually the least likely to alert the sufferer that something is wrong. LPR can be distinguished from GERD because chronic heartburn is not a symptom of LPR, whereas it is the primary symptom of GERD. The symptoms of LPR are listed below. If you experience any combination of these symptoms for over a week and they are not relieved by normal cold medications, contact your doctor for an appointment.

  • Hoarseness
  • Chronic cough, usually low grade and dry
  • Asthma-like symptoms, sensation of a closing throat
  • Repetitive throat clearing
  • Sensation of a lump in the throat
  • Sensation of excess mucus in the throat
  • Trouble swallowing
  • Chronic, low grade sore throat
  • Bitter or sour taste in the mouth and halitosis (bad breath)

Children and infants can also have LPR, however diagnosis is difficult when the children are very small and cannot verbalize symptoms. Symptoms in infants and children include:

  • Noisy breathing or pauses in breathing
  • Spitting up often
  • Food inhalation
  • Trouble feeding
  • Lack of sufficient weight gain

Cause of GERD and LPR

The root cause of all GERD and LPR symptoms is the same. Acid reflux causes pain and damage when stomach contents are overly acidic and they are allowed back into the esophagus by the lower esophageal sphincter (LES). The primary function of the LES is to open when food is swallowed, so food can travel from the esophagus into the stomach, and then to close again so stomach contents stay in the stomach. The stomach must produce acids to brake down foods before they enter the intestines. Stomach acidity is usually quite high anyway, but in GERD sufferers acidity is usually higher than normal. Highly acidic stomach contents can cause serious damage to the esophagus, even if no heartburn is felt.

In infants, LPR can occur very easily. Babies are often lying down, and they feed lying down. The esophagus is short and the lower esophageal sphincter has not necessarily developed proper function.

Diagnosis and Treatment

GERD and LPR will usually be diagnosed without any tests. Your doctor must rely on an accurate description of any and all symptoms you experience. It is very important that you write down your symptoms, and always include symptoms that you may or may not think are related. If you believe you have a cold that has lasted for three weeks, you may not link your symptoms to a case or two of heartburn. However, omission of heartburn can lead to a misdiagnosis, which leaves the esophagus open to further damage from untreated GERD or LPR.

There are some tests that can be done to determine acidity of the stomach or frequency of acid reflux. Your doctor can also perform relatively simple procedures that will determine whether or not the lining of the esophagus is damaged.

However, before any treatments that require testing are performed, your doctor will probably instruct you to carefully monitor your eating habits and take note of foods and beverages that trigger symptoms. Your doctor can probably provide you with a list of potential triggers, and that list will always include alcohol, tobacco products, and caffeine. Avoid spicy, fatty, or sugary foods and eat smaller meals to reduce the acidity of the stomach.

Another very common reason that people develop GERD or LPR is being overweight.Similarly, pregnant women suffer frequent heartburn. This is because the extra weight on the abdomen pushes on the internal organs. Even a tight belt can cause the stomach to work less efficiently, and stomach contents can be kept from moving on into the intestines. When the stomach has pressure on it, stomach contents also move around and sometimes up towards the LES.

To help reduce the likelihood of suffering from GERD or silent reflux, do not lie down after meals. Never put pressure on the abdomen or chest after eating, and wear loose clothing. Try to eat smaller meals, even if it means eating more frequently, as overstuffing the stomach will have negative effects on the LES. And eat slowly, because if you give the esophagus, LES, and stomach time, they will work properly.

For infants who seem to be suffering from LPR, the best way to avoid discomfort for them is to keep the baby upright for at least 30 minutes after each feeding.Consider more feedings, closer together. The mothers diet can also seriously effect the baby and care should be taken in all aspects of diet.

With any symptoms you experience, it’s always best to consult your doctor to find out what you can do to eliminate more serious conditions and identify silent diseases like LPR. Be sure to record any and all symptoms carefully, and include frequency, timing in relation to meals or exercise, and duration of symptoms.