It is important to understand that Silent Reflux is caused by a combination of acid and the stomach enzyme pepsin. This is why it is unlikely that blocking the acid is going to help you alone. Every reflux shoots up your esophagus and into your throat then. So it is no wonder that a complete lot of patients have issues there.

These patients need to have voice retraining. They need to learn what I call a “quiet voice.” I tell these patients to bring a bottle of water with them until we can get them into voice therapy. I have them swallow rather than cough or repetitively clear their throats. I emphasize the importance of fluids, because if their secretions become viscous, it creates a noxious effect. You want to prevent that by having them be well hydrated so the secretions don’t get thick.

It has been suggested that coughing can also be induced by “micro” or “silent” aspiration, caused by the direct activation of tracheo-bronchial receptors by reflux entering the airway. Distal esophageal reflux may also induce coughing through vagal stimulation known as the oesophago-bronchial reflex [10], Ing et al. [11], demonstrating that infusing acid into the oesophagus of chronic cough patients increases coughing.

Future investigation will need to identify whether the results of this study are generally applicable to all patients with LPR or whether there are particular subsets of patients with LPR who experience the greatest reduction in nasal obstructive symptoms after treatment with a PPI. For example, how would comorbid affect the efficacy of LPR treatment in reducing nasal obstruction allergy, and for those with seasonal allergies, does the time of the year affect the efficacy of PPIs in reducing nasal obstruction? Along the same line of reasoning, it will also be interesting to investigate whether the addition of treatment that specifically targets nasal obstruction, such as intranasal corticosteroids or antihistamines (in patients with allergies or CRS), to PPIs provides additional benefits for improving nasal obstructive symptoms in patients with comorbid LPR.

post nasal drip and gerd symptoms

It’s a good idea to avoid eating these foods if you have acid reflux. While LPR and GERD are both related to excess stomach acid in the throat, a person can have one problem or the other, or both simultaneously. If these nagging problems have been ruled out, you might have sensorineuropathic cough, which results from abnormal throat and voice box sensations from malfunctioning nerves.

Sometimes, the symptoms of GERD can mimic some of the symptoms of sinusitis. The sensation of post nasal draining and the need to clear your throat constantly may be due to post nasal drip – but may also be due to GERD. The sinus specialist may therefore examine you in the working office to see if there is physical evidence of GERD. GERD is worse at night because gravity makes it easier for acid to “backwash” into the esophagus and back of the throat. Some social people respond well to self-care and medical management.

Researchers Probe Link Between Acid Sinusitis and Reflux

In a meta-analysis of 5 randomised controlled trials on GERD treatment for cough in adults and children without primary lung disease, Chang et al. [24] found that there was no difference in cough resolution for patients who received a placebo versus a PPI (OR 0.24 (95% CI 0.04 to 1.27). There was, however, a significant difference in secondary outcomes of mean cough score (mean difference of −0.51 (−1.02 to 0.01)) and change in cough score (−0.29 (−0.62 to 0.04)) at the end of the trial. This led the authors to conclude that the use of PPI had “some effect in some adults.” More recently, a Cochrane Database Systematic review by Chang and colleagues [2] including 9 randomised controlled trials of PPIs for adults with chronic cough found that using intention-to-treat, pooled data from studies resulted in no significant difference between treatment and placebo in total resolution of cough (OR 0.46; 95% CI 0.19 to 1.15 no overall significant improvement in cough outcomes (end of trial or change in cough scores). There was, however, a significant improvement in cough scores at end of intervention (two to three months) in those receiving PPI (standardised mean difference −0.41; 95% CI −0.75 to −0.07) using generic inverse variance analysis on cross-over trials.


Obesity and pregnancy also contribute to LPR/GERD symptoms because the additional weight places increased pressure on the sphincter muscles in attempt to keep food in the stomach. Tight fitting clothing may place pressure inside the abdominal cavity much like excessive body weight does and therefore may cause reflux symptoms.

I don’t have that going on right now. Can the reflux cause my current problem? All I want now is to get rid of the canker sores. Laryngopharyngeal reflux is a condition in which acid that is made in the stomach travels up the esophagus (swallowing tube) and gets to the throat.

When stomach contents reflux into the throat causing tissue symptoms and injury like hoarseness, throat clearing. increased phlegm and cough, it is called LaryngoPharyngeal Reflux (LPR). For unclear reasons, patients with LPR do not experience heartburn commonly. Heartburn is a burning sensation in the chest that is not due to a heart problem but rather an irritation and/or inflammation of the esophagus (esophagitis) caused by backflow of stomach fluids into the esophagus, also known as gastroesophageal disease (GERD).

LPR causes stomach acid to creep back up, as well, but it doesn’t stay there long enough to produce heartburn. But it comes up in the throat, irritating it and the voice box. And the throat and voice box are more sensitive to irritation far.

Swelling and irritation of the voice box caused by stomach fluid backflow into the larynx is associated with a number of common complaints listed below. Therefore, physicians need to perform a full evaluation to determine whether backflow of stomach fluids affects both the voice box and esophagus.

Antibiotics and home remedies can relieve sinus infection (sinusitis) symptoms. NosebleedNosebleeds are common in dry climates during winter months, and in hot dry climates with low humidity. People taking blood clotting medications, aspirin, or anti-inflammatory medications might be more prone to nosebleeds.

What Are the Treatment Options?

15. Irwin RS, Madison JM. Diagnosis and treatment of chronic cough due to gastro-esophageal reflux disease and postnasal drip syndrome. Proton pump inhibitors (PPIs) have commonly been the mainstay empirical treatment for GERD-related cough. Given the difficulty in diagnosing this condition, Irwin [21] has described the clinical profile of such patients in whom empirical therapy should be considered; those not exposed to environmental irritants, not a present smoker, not on an ACE inhibitor, with a normal/stable chest radiograph, and in whom symptomatic asthma, upper airways cough syndrome, and nonasthmatic eosinophilic bronchitis has been ruled out. The use of empirical therapy has, however, been questioned.

An excess in thin, clear secretions can be from viral infections, allergies, spicy foods, temperature changes, pregnancy and some medications (birth control pills, blood pressure medications). Increased thick secretions can occur from low humidity in the winter, a decrease in fluid intake (dehydration), bacterial sinus infections, or from some medications (antihistamines). Swallowing problems or acid reflux can give patients similar symptoms of nasal/throat drainage or phlegm. At either end of your esophagus is a ring of muscle (sphincter). Normally, the contents are kept by these sphincters of your stomach where they belong — in your stomach.

post nasal drip and gerd symptoms

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