Science has known since the 1960’s that there is an association with reflux and laryngitis (inflammation of the larynx). Often when we think about silent reflux we think of children, but silent reflux also has a huge prevalence in adults, often going undiagnosed for years. Many believe that reflux only affects the oesophagus, unfortunately it has far greater reaching effects. The acid can also travel up to the upper sinus passages, throat and ears causing a plethora of seemingly odd symptoms that don’t seem to fit the bill for other conditions.
“A chronic non-infective cough is one of the most classic symptoms in adults with silent reflux”
How does silent reflux present in an adult? The most classic presentation is a chronic non-infective cough, which could be occurring all the time but can also just occur after a meal or when a person lays down. Another key distinction is there will be no heartburn, no regurgitation, no other classic “reflux” signs.
Other Symptoms to Look for:
- Hoarseness of the voice
- Pain with speaking
- Voice that dwindles out because they can’t project their voice
- People who have to clear their throat routinely
- Excess throat mucous
- Post nasal drip
- Difficulty swallowing
- Feeling of a lump in throat
- Chronic sore throat, often times a person will say “I wake up with a sore throat”
- Asthmatics – 58-90% have some degree of reflux and oesophageal disorders
- Strange sensations in mouth sometimes described as tingling on the tongue
- Pain or congestion in their ears after eating
It’s important to seek a correct diagnosis as people with silent reflux if left untreated can progress to Barrett’s Oesophagus and in some cases Oesophageal cancer. Another important point to mention is research has found that people who lack an enzyme which converts carbon dioxide into bicarb are at an increased risk for developing cancer. This is because they lack the ability to neutralise the acid travelling up the oesophagus with bicarb. But guess what? You can do something about it, that enzyme is heavily dependent on zinc for its expression and function.
Standard Medical Treatment
PPIs (proton pump inhibitors) have been the go to treatment for silent reflux, unfortunately randomnised controlled trails have yielded very poor results for patients.
A Naturopathic Approach to Treatment
- Correct a zinc deficiency, zinc can be tested via blood. Ask for a Plasma Zinc test. Levels over 14 indicate healthy zinc status.
- Melatonin ~ speeds up stomach emptying and acts as an antioxidant. Research has shown 3 mg morning and night to be effective
- 25mg of Betacarotene everyday as carrot juice or tablet particularly helpful for patient who already have Barrett’s.
- Dietary modifications to reduce the relaxation of the lower oesophageal sphincter
- Reduce concentrated fats & acidic beverages
- Minimise alcohol
- Minimises canned foods, science yet don’t understand the reasoning but strong correlation
- Avoid peppermint
- Reduce meal sizes
- Don’t lay down between meals
- Chewing gum 30 minutes before a meal and just before bed
- Probiotics ~ Lactobacillus reuteri MM53 has been shown to be effective
- Slippery elm