Silent Reflux: A Caustic Condition
LPR stands for Laryngopharyngeal Reflux (sometimes called “silent reflux”) because it does not cause the traditional reflux symptoms of heartburn or indigestion. However don’t let the name fool you. This condition can cause irritation and damage to all parts of the airway, including the nose, throat, voice box, sinuses, lungs and trachea.
Despite being similar to acid reflux (GERD), symptoms may also be dissimilar. For example, heartburn, is one of the most common acid reflux symptoms, but it isn’t typically associated with silent reflux. However, silent reflux can result in some serious side effects, including inflammation, scarring of the tissues and even laryngeal cancer if left untreated.
LPR is a condition in which stomach contents (such as the food you eat, or the acid produced by the stomach) travel from your stomach, up your food pipe, and into your throat. Although we have muscle valves at the top and bottom of our food pipes that are supposed to prevent this from happening, they are not effective 100 percent of the time. What’s even more strange, even when they work well, you can still get symptoms of LPR. (UT Southwestern Medical Centre)
The most common symptoms in adults include:
feeling like something is stuck in the throat
frequent throat clearing
a bitter taste at the back of the throat
swelling and irritation of vocal cords
a sensation of post-nasal drip
Source: Medical News Today
The good part is that you don’t need to go on medications. There are natural ways to address this situation and if you’ve ever suffered from it, you’ll welcome this advice because LPR can feel like a hammer hit you.
There are two principle root causes for acid reflux. The first is a microbial imbalance in the digestive tract.
The second is low acidity.
Here are some ways to relieve silent reflux:
An imbalance in the microbes that colonize your intestinal tract can be catastrophic to your digestion. Your gut microbiome is considered ‘unbalanced’ when the proportion of beneficial microbes is outnumbered by their harmful counterparts.
The wrong bacteria such as H Pylori or Clostridium Difficile (C. Diff.) can grow out of proportion in your stomach, leading to fermentation and excess gas production which causes bloating (a common reflux symptom).
When our microbiome is unbalanced, food contents sit on your stomach for extended periods, leading to indigestion (another common reflux symptom). As this occurs more often, this creates a cycle that supports further colonization of bad bacteria, which in turn leads to higher frequency and severity of indigestion.
Often, the trigger for this condition is simply a bad diet of excess unhealthy fat, refined sugar and salt (a.k.a. unhealthy foods). Improve your diet with increased vegetables, proteins and healthy fats, as well as less refined starchy foods and you improve your digestive health.
In other cases, there are trigger foods that also cause silent reflux, but which in many cases are merely the resultant condition laid down by a bad diet.
1. Reduce trigger foods
Certain foods may relax the esophageal sphincter, allowing acid to flow into the esophagus, aggravating symptoms and worsening reflux. Citrus fruits are known to trigger reflux symptoms and should be limited or avoided on a silent reflux diet. These include oranges, lemons, limes, grapefruit, pineapple, tomatoes and tomato sauce.
High-fat foods like full-fat dairy products, fatty cuts of meat, fried foods and desserts take longer to digest and can slow stomach emptying. They may also relax the esophageal sphincter and allow stomach acid to enter the esophagus. Reducing your fat intake and limiting consumption of high-fat foods can help sidestep symptoms of silent reflux.
Chocolate, mint, onions and spicy foods are also common culprits when it comes to silent reflux, though certain foods may affect individuals differently. Starting a food diary to track your intake and figure out which foods spark symptoms for you is a great way to identify your trigger foods and tailor your diet accordingly.
In a nutshell:
Some of the more common dietary triggers may include:
Fried or fatty foods
Carbonated beverages (Soda, sparkling water, beer)
There can also be a high degree of difference in triggers from one person to another. This is why it’s important to tailor your nutrition approach according to symptoms and eliminating trigger foods. (healthline.com)
2) Sit up after eating
Lying down right after eating is a major cause of reflux as it makes it much easier for stomach acid to back up and flow in the wrong direction. So after a meal, sit upright or even walk around a bit to promote proper digestion and avoid reflux. As a general rule, don’t lie down for at least two to three hours after eating to give your food a chance to digest and prevent back flow. Additionally, keeping your upper body elevated by propping up the head of your bed or pillow may also be useful to avoid symptoms overnight.
3. Exercise regularly
One study in Sweden even found that regular exercise was associated with a decreased risk of reflux symptoms. The most recent Dietary Guidelines for Americans recommend at least 150 minutes of moderate intensity exercise or 75 minutes of vigorous intensity exercise per week.
But keep in mind that exercising shortly after eating may worsen reflux to a greater extent, as will certain forms of exercise. High-impact exercises that may cause increased problems include:
4. Limit carbonated beverages
Carbonated beverages like soda can significantly worsen reflux. This is because the bubbles expand in the stomach, causing abdominal distention, increasing pressure on the esophageal sphincter and leading to reflux. Limiting your intake of drinks like soda, ginger ale, root beer and even carbonated water can make a big impact on reducing silent reflux symptoms. (Journal Gastrointestinal Disorders)
5. Follow a healthy diet
Eating a healthy diet full of nutrient-rich, unprocessed foods can benefit many aspects of your health and may even help ease symptoms of silent reflux. A 2017 study on silent reflux showed that dietary modifications reduced symptoms by a whopping 40 percent. Fill your plate with plenty of whole, unprocessed foods like non-citrus fruits, vegetables and lean meats.
Additionally, you may benefit from:
Adding naturally fermented foods to your diet (for probiotics)
Taking apple cider vinegar for prebiotics and to kill harmful pathogens
Using digestive enzymes with meals to improve digestion
Taking betaine hydrochloride and pepsins with meals to restore acidity and sphincter function
Some dietary triggers may be less obvious, which is why an elimination diet is often helpful.
Foods and drinks that have been associated with the development of or symptoms of LPR include:
tomatoes and tomato-based foods
Source: Medical News Today
In other cases, certain kinds of foods may indirectly contribute to reflux without necessarily causing immediate symptoms. Cut out all refined starches, including wheat (even whole). Eat grains you have to cook (like oats) to make sure all nutrients, and fiber are present to see the biggest benefit when it comes to silent reflux.
6. Avoid tight-fitting clothing
Trading in tight jeans and opt for looser fitting, more comfortable clothing to make a big impact on your symptoms. Tight clothing can increase the pressure on your stomach and push stomach acid up, causing reflux.
Source: Medical News Today
7. Avoid caffeine
Caffeine has been shown to worsen symptoms in some people with silent reflux. This is because caffeine can relax the esophageal sphincter, allowing acid to enter the esophagus and cause reflux. Coffee, tea and soda are some of the most common sources of caffeine in the diet. If you find that these exacerbate your symptoms, you may want to consider eliminating them from your diet. (Tampa Bay Reflux Center)
8. Eat small, frequent meals
Eating too much food places increased pressure on the stomach and can cause acid to be pushed up into the esophagus. Dividing your daily intake into smaller portions and eating more frequently can keep you full, help you avoid overeating and prevent reflux. Planning nutrient-dense, portion-controlled snacks throughout the day is the easiest way to do this. Make sure your mini meals contain plenty of nutrient-dense foods like fruits, vegetables and whole (cooked) grains with a good source of protein to optimize your intake.
Smoothies with comprehensive green powders and/or some added protein and a small hand full of fruit may help greatly. They are easy to digest and full of nutrients. Vegetable soups are also of great aid.
Eat bitters stimulate digestive secretions such as saliva, stomach acid, digestive enzymes and bile. They prepare the stomach and intestines for digestion. Adding bitter foods in your diet such as arugula, kale and dandelion greens is a good place to start. (Dr. Nandi)
9. Chew (healthy) gum
Chewing a piece of gum after your meal can be a quick and easy remedy to fight against silent reflux. A 2005 study found that chewing sugar-free gum for half an hour after eating was able to reduce reflux because it increases saliva production, which can neutralize stomach acid. It also causes you to swallow more often to help clear acid from the mouth and esophagus more quickly. Keep in mind that peppermint causes symptoms for some people. So opting for another flavor like cinnamon may be a safer choice. (NHS)
10. Avoid alcohol
Some evidence shows that drinking alcohol may trigger symptoms of silent reflux because it affects the sphincter. By the same token, most alcoholic drinks are acidic and carbonated, further worsening silent reflux. Alcohol itself can also irritate the already sensitive tissues of the throat.
Most people find it difficult to abstain from alcohol, but it would at least make sense to limit its consumption. Furthermore, when people get drunk, they also often eat late, e.g., after going out. This is a problematic combination, considering that they will now sleep with a full stomach and an impaired lower esophageal sphincter, leading to heavy reflux all night long. Always avoid drinking two to three hours before bedtime. (Refluxgate.com)
11. Add high fiber foods to your diet (prebiotics) to rebalance your gut
Some studies have found that increasing your fiber intake could fight against silent reflux. High-fiber foods include non-citrus fruits, vegetables, legumes and whole grains. Men should eat at least 38 grams per day. Chia seed is a great addition to the diet, as is a prebiotic fiber such as Jerusalem Artichoke. Make sure to increase intake slowly. Also, drink plenty of water to avoid the negative digestive symptoms that can accompany sudden increases in fiber intake. (Stamfordentcenter.com)
A) Aside from the dietary changes, black seed oil helps to lower inflammation in the esophagus and lungs.
**Please note: The links included are for reference and information. They do not constitute a monetary gain for me.
B) Sulforaphane from broccoli sprouts also helps the body generate its own antioxidants. This also helps to protect both the lung and esophageal lining from repeated damage.
C) Take some digestive bitters before meals. Bitters can help to prevent reflux in the first place by improving the tone of the lower esophageal sphincter. This is the flap that protects our stomach acid from flowing back up into the esophagus. Keeping this sphincter working properly is imperative for those suffering with reflux of any kind.
They may not be suitable if you have acid reflux as they can increase stomach acid and worsen symptoms. More often they are helpful in non-acid reflux which we see commonly in silent reflux.
D) Chia seeds - helpful because of added fiber
E) Prebiotic (Jerusalem Artichoke or Blue Agave) - helps with your own bacteria
**Sadly, people are lulled into believing medicines are helping them because they neutralize the uncomfortable / painful acids that escape into the throat. Consequently they don’t understand that medicines do not treat the root cause of this condition. It is well documented that their long term use leads to several vitamin deficiencies, namely vitamin b12, magnesium, and calcium. This also leads to a laundry list of health symptoms.
As silent reflux is a multi-pronged issue, including digestion issues, microbial imbalance, malabsorption, and low acidity, the solution needs to be one that addresses all of these issues.
All the best in your digestive journey. You should see good results in about 4 weeks if the above steps are implemented.