Breathing problem: Silent Reflux a hidden epidemic
Often overlooked and misdiagnosed, silent reflux affects over 50 million Americans. The backflow of stomach acid and digestive enzymes (pepsin) can wreak havoc on your esophagus (the food passage that goes from your throat to your stomach), as well as your ears, nose, throat, vocal cords, sinuses, mouth, and lungs. Pepsin, in the presence of acid, digests protein and damages tissue. Outside the protected stomach, pepsin, bathed in acid, digests you! And when pepsin attacks your sensitive airway and esophageal tissues, you can suffer all kinds of problems.
The most common silent reflux symptoms are hoarseness, chronic cough, throat-clearing, post-nasal drip, sinusitis, sore or burning throat, difficulty swallowing, shortness of breath, snoring, sleep apnea, bad breath, tooth decay, asthma, and COPD. Unfortunately, your doctor is probably unaware that these symptoms may be caused by silent reflux and that it could be controlled with the proper diagnosis and treatment.
Did you know that asthma is one of the most common misdiagnoses, because silent reflux mimics asthma? Here’s a big tipoff: When you have trouble breathing, do you have more difficulty getting air IN or OUT? People with reflux have trouble getting air IN during inspiration (not out during expiration). People with asthma have difficulty getting air OUT of the lungs. In truth, many people with “asthma” may not actually have it, and, consequently, asthma medication doesn’t really help much if at all. The fact is that once the correct diagnosis is made, effective anti-reflux treatment can permanently cure this asthma-like breathing problem.
How Do I Know If I Have Silent Reflux?
One of the characteristics of silent reflux is that most people who have it have several different symptoms all at the same time, but often heartburn isn’t one of them.
To find out if you may have silent reflux, take this simple quiz. Just circle the number for each symptom and add up the numbers. The quiz is actually known as the Reflux Symptom Index (RSI), and it is a great first test to see if you have reflux. If your RSI is 15 or more (and you have a zero or one for heartburn), you may have silent reflux; you should see a specialist trained in detecting reflux by examination of both the throat and esophagus. Doctors who only scope the esophagus are missing the boat. Get your printable version of the Reflux Symptom Index.
Why Is Reflux Sometimes Silent?
What makes silent reflux different than heartburn is that the silent reflux sufferer may be unaware of having it, and his or her doctor may not suspect the diagnosis. A lot of reflux is needed to damage the esophagus, but very little reflux can severely damage the more sensitive throat, sinuses and lungs. Many people with silent reflux have never even once experienced classic heartburn.
How the term “silent reflux” came to be is instructive. In 1987, Walter Bo, a medical school colleague, was my patient. As a result of nighttime reflux, he had terrible morning hoarseness. This was because he had a habit of eating dinner very late and then falling asleep on the sofa. Hence, he would reflux into his throat all night.
I tried explaining the problem, but Walter repeatedly denied having reflux. As it turned out, Walter affirmed that he thought that heartburn and reflux were the same. When I was able to explain that one could have reflux without heartburn – as in this example, when it occurred during sleep – Walter rolled his eyes and said, “I see. I have the silent kind of reflux.” I declared, “Yes, Walter, that’s it! You have silent reflux!”
Why Doesn’t My Doctor Know About This?
Unfortunately, people with silent reflux symptoms, even if they ask their doctor, are usually incorrectly told they do not have reflux. The medical specialties are broken down by parts of the body, and doctors are experts in, and only test for, those parts of the body in which they specialize. The problem is that reflux does not care where your doctor trained and how it might affect the different medical specialties – the esophagus treated by gastroenterologists, the throat and sinuses treated by ear, nose and throat specialists (otolaryngologists), and the trachea and lungs treated by lung specialists (pulmonologists).
The Solution: Integrated Aerodigestive Medicine
Only a trained reflux specialist who knows what to look for in all affected areas and who has the right diagnostic tests is equipped to make an accurate diagnosis. Otherwise, a doctor may guess wrong and treat you for an illness that you don’t have. Some of the symptoms of silent reflux can sometimes be caused by other diseases, which doctors try to treat unsuccessfully, leaving you miserable, frustrated, and having wasted money on useless tests and drugs.
Instead of focusing on the patient’s diet and lifestyle – the root cause of almost all reflux disease – doctors often employ pills, usually the wrong pills, that rarely correct the problem. In truth, reflux medications are grossly misused and over-used today.
Interested in more discussions like this? Go to the Lung Health Support Group.
Excellent- Thank you for posting
Thanks I though it will be worth looking at other aspects !
I was diagnosed with silent reflux a 3 years ago but couldn't tolerate the medications.
What medications are the wrong medications? I've used them all, I think.
I have history of duodenal ulcer, acid reflux I have officially been diagnosed with GERD since my late 20s and I'm 63 now.( My father died of stomach cancer at age 47, had reflux most of his life then.) I've taken omeprazol for about 10 years for GERD. I went last month to my GI and had stomach and esophagus scoped (my recent Nov diagnosis of PH and use of steroid inhalers created hoarseness and total laryngitis daily since Nov, suspicion of esophageal thrush or vocal cord thrush.) Scope result was gastritis in stomach and very irritated esophagus from acid reflux, but no thrush. He suggested ENT for vocal cords, who I saw and he scoped my vocal cords, no thrush, but irritation from acid reflux! I stopped steroid inhaler and doubled dose of omeprazol. Got my voice back first time without hoatseness since use of steroid inhaler, but in a month my breathlessness increased. I cant win! I'm physically debilitated when I move about, muscle fatigue in hips, legs and low back. I feel awful! My life how knew it is gone! I hate PH! Only time in my life I've had GERD so severe and no heartburn!
Ever try something as simple as aloe water…
Not, aloe juice… straight aloe water… the brand my husband uses is “george’s”…acid reflux went away…about 2 shot glasses each day… worth a try!
Doctor told me I have Silent reflux after he did an endoscopy, Grade C esophagitis, been having SOB for about 4 months now and he has been giving me Prilocec 40mg twice a day with no improvement so far almost two months of the meds) I am coping with these symptoms and trying to work around them. Very un pleasant, hope I can find some relief! Best wishes everyone
I am trying to locate George's Aloe Water. Is it the same as George's 100% Aloe Vera Fractionally Distilled Liquid from Aloe Vera Leaves I can get through Amazon. Do you mix it with water? Please help, struggling with Silent Reflux…thanks so much. Kate
@kmjc– Welcome to Mayo Clinic Connect. Why have you decided to try Aloe water? Have you had any tests or seen a doctor for this?
Does anyone have this? I have it, and working on trying to know more about it. My story is I have COPD and coughed for years. Was a smoker but even quiting didn't help. I finally feel like I have a good doctor. All the doctors tell me sinus problems. It's the COPD. It doesn't seem that medicine helps. So frustrating to not get the right answers. This doctor I am seeing is a pulmonary doctor, however if I have to see a gastroenterologist I will. I am tired of this cough running my life.
I have it too according to my GI Dr. I then had an upper scope EGD and was told I have Barrett’s esophagus. Anyone who smokes has reflux. It loosens the les muscle and you get reflux. I changed my diet to a strict low acid diet and on my last scope I had no sign of Barrett’s. No booze, no soda, no smoking, no tomato or vinegar based foods. No Italian, Mexican or spicy foods. Low acid coffee is ok. No lemons, limes, apples, eat ripe bananas and melon. Eat baked chicken, baked potato. Cheerios are good in the morning with unsweetened almond milk which is alkaline. No more fried fatty foods or eating out at fast food joints. This works for me. No eating 3-4 hrs before bedtime. Raise the head of your bed 6”. Buy the book the acid watcher diet off Amazon. Great info on this reflux disease. Good Luck on your new diet.