What Are the Most Common Symptoms of Acid Reflux?

Over the past 50 years, the symptoms of acid reflux have changed from esophageal, e.g., heartburn and indigestion, to respiratory … and often it’s silent reflux. Acid reflux no longer falls in the practice of the gastroenterologist; it is now almost exclusively in the domain of the otolaryngologist, the ear, nose, and throat physician … and s/he heeds additional training in how to diagnose and treat respiratory reflux. Here are the top 7 symptoms of acid reflux in decreasing order of frequency.

1. Post-Nasal Drip, Too Much Mucus 

Today, the most common symptom of acid reflux is Postnasal Drip or Too Much Mucus. This postnasal drip is always thick, whereas allergy mucus is thin and usually associated with other allergy symptoms such as sneezing, runny nose, and itchy eyes.

The new term for LPR (laryngopharyngeal reflux), Respiratory Reflux (RR), helps explain why this is the number one symptom. Why? Because the lining of the respiratory system is made up of mucous membranes. And what do mucus membranes do when irritated? They make more thick, Elmer’s-glue-like, mucus.

2. Chronic Throat-Clearing

The thick post-nasal drip of respiratory reflux gets stuck where it is hard to move, especially on the vocal cords and in the back of the nose. You’ve seen some poor television announcer or personality get mucus stuck on the vocal cords, resulting in loud and disruptive throat clearing. Because of thick mucus, chronic throat clearing is the number two symptom of RR. BTW, I think that President Biden may have this. 

3. Shortness of Breath

The term “Respiratory Reflux“ actually has a double meaning. The first is that any part of the respiratory system may be involved with acid reflux, and the second is that it can cause respiratory problems, namely, breathing problems such as Shortness of Breath. Indeed, asthma, choking episodes, laryngospasm, paradoxical vocal cord movement, and difficulty getting air into the lungs … all caused by RR. In addition, chronic bronchitis and lung problems like COPD are exacerbated, worsened, and accelerated by RR.

Also, there is one symptom that is exclusively associated with RR: difficulty or discomfort, such as taking a full breath. If you have this type of shortness of breath, you most certainly have RR. Difficulty taking a breath fully has only one cause, 

4. Hoarseness

Often, people with hoarseness from RR are unaware that RR is the cause. However, it is often associated with silent nighttime reflux, i.e. SNoRR. This type of hoarseness is due to vocal cord swelling.

5. Lump-In-The-Throat Sensation

A lump in the throat sensation, also called Globus, is almost always related to RR. The main cause is that the upper valve just behind the voice box loses normal control, and pressures can be abnormally high. This should be differentiated from too much throat mucus.

6. Chronic Cough

A chronic cough in a non-smoker with a normal chest x-ray is almost always due to respiratory reflux. Such people typically have a productive wet cough. They cough after eating, lying down, and sometimes awake coughing in the middle of the night. I’ve written a book on this, The Chronic Cough Enigma.

7. Heartburn

It should seem obvious to you that if heartburn is the seventh most common symptom of acid reflux today, RR is much more common and important than esophageal reflux or GERD. This is the big change in the acid reflux story, namely that RR (usually silent, i.e. SNoRR)  is the predominant pattern of acid reflux. Indeed, RR is so common that it is almost cultural due to the fact that we tend to eat late and make the evening meal the largest meal of the day … often with alcohol as well.

The gastroenterologists is of no use in the diagnosis and treatment of respiratory reflux.

Subscribe to this blog (see below) to stay current; if you would like to schedule a virtual consultation with me, you can Book It Online.