Condition
Clinical term: Laryngopharyngeal reflux (LPR); gastro-oesophageal reflux disease (GORD)
Reflux occurs when stomach contents travel upward into the oesophagus and, in some cases, reach the throat and voice box. Laryngopharyngeal reflux (LPR) — sometimes called silent reflux — affects the throat region and often occurs without the classic heartburn that patients associate with reflux. It is a common and under-recognised cause of chronic throat symptoms.
Symptoms
Causes
The valve between the stomach and oesophagus not closing fully, allowing stomach contents to reach the throat - this can relate to diet, body weight, eating habits, or individual anatomy.
Dietary triggers including caffeine, alcohol, fatty or spicy foods, and eating large meals.
Eating late at night or lying down shortly after meals, which increases the likelihood of reflux events.
Being overweight, which increases intra-abdominal pressure and is associated with more frequent and severe reflux.
Unlike typical heartburn, many people with LPR feel no burning in the chest - which is why the condition is often not recognised without specialist assessment.
Koufman JA. Laryngoscope. 1991;101(Suppl 53):1-78. Lechien JR et al. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(2):101-108.
When to seek help
Seek specialist review if throat symptoms persist beyond several weeks despite dietary changes, if hoarseness is not settling, or if swallowing is affected. An ENT assessment is important to examine the throat and vocal cords directly — LPR shares symptoms with other conditions that require their own management, and accurate diagnosis matters. Prompt review is warranted when symptoms are associated with weight loss, difficulty swallowing solids, or blood in mucus.
Treatment
Assessment involves direct visualisation of the throat and larynx using nasendoscopy, which allows the characteristic changes of LPR to be identified. Management typically begins with dietary and lifestyle modification — reducing trigger foods, adjusting meal timing, and elevating the head of the bed. Acid-suppressing medication is often recommended. Symptoms from LPR can take several months to fully settle with consistent management. If there is uncertainty about the diagnosis or an incomplete response to treatment, further investigation with a gastroenterologist may be coordinated.
Related procedures
Choosing your surgeon
Choosing the right specialist takes thought. Fellowship training, experience with the relevant condition, and contribution to teaching and research are all meaningful indicators. A public appointment at a tertiary hospital is another recognised marker of professional standing. Online reviews can be helpful, but they don't tell the whole story.