Acid reflux is often associated with heartburn. However, it can also manifest as silent reflux or laryngopharyngeal reflux (LPR). These conditions have different symptoms, but may overlap and can be treated similarly.

Acid reflux is a common problem. It happens when the acid your stomach makes to digest food travels back up into your esophagus, where it doesn’t belong. When you have these symptoms often it might be a chronic condition called gastroesophageal reflux disease (GERD).

When you think of acid reflux, you generally think of heartburn symptoms like chest pain or a burning feeling in your throat, which is caused by stomach acid rising into the esophagus.

However, acid reflux can also cause “silent reflux,” or LPR, which is when your stomach acid goes up into your laryngopharynx. This marks the point where the pharynx splits into the larynx on its front side and the esophagus on its back side. LPR has different symptoms than GERD, but both conditions are managed with many of the same treatments.

LPR and GERD are both types of acid reflux, but the symptoms are different.

GERD (or acid reflux) is typically associated with heartburn. In contrast, LPR may cause symptoms that feel more like a cold or an allergy, or it may cause no symptoms at all. This can make LPR hard to diagnose.

Both conditions can also cause difficulty with swallowing or dysphagia. People with GERD tend to have pharyngoesophageal dysphagia, which is when you have difficulty swallowing lower in the throat and chest, and may feel like food is stuck there. On the other hand, people with LPR may experience oropharyngeal dysphagia, which is experiencing difficulty as soon as you begin to swallow.

Learn more: Symptoms of GERD vs symptoms of LPR and here is a summary of the differences in symptoms.

GERD SymptomsLPR Symptoms
difficulty with lower throat swallowing/food stuck feelingdifficulty starting a swallow
burning feeling in the chestchronic cough
pain in your chest when you lie downvocal hoarseness
burning feeling in your throatsore throat
bad taste in the back of your throatshortness of breath
pain that occurs at night and wakes you upred, swollen, or sore voice box

In children

Note that children and infants can have different GERD symptoms than adults because the muscles in their stomachs and esophagi are not strong and developed yet.

Similarly, LPR can present differently in babies. The baby may still appear as if it has a cold, but it may also experience trouble breathing, difficulty feeding, spitting up, and growth delay.

Since there are many causes for these symptoms in babies, it’s a good idea to take your baby to a pediatrician for an evaluation.

Medical emergency

If your child’s skin color begins to turn blue, call 911 or go to the nearest emergency room immediately.

GERD is very common, affecting around 20% of Americans. By contrast, the prevalence of LPR varies, estimated to be about 5% to 30% depending on the study and examined population.

The prevalence of LPR among infants is harder to estimate but is believed to be in about the same range.

Can you have GERD and LPR at the same time?

It’s possible for GERD and LPR to overlap. For example, in a 2018 study of 80 people with GERD, 57% were also found to have LPR.

Both GERD and LPR are caused by acid reflux. When you digest food, the rings at the bottom of the esophagus, called sphincters, shrink to prevent the contents of your stomach from going up into your esophagus.

When you have acid reflux, this mechanism doesn’t work as it should. Your sphincter might not close properly. This can lead to both GERD and LPR.

In GERD, some of your stomach contents travel up to your esophagus, causing the burning sensations associated with the condition. In LPR, stomach content travels all the way up to the back of your throat, causing a cough and sore throat.

Flares of both conditions can be triggered by factors such as eating certain foods, smoking, drinking alcohol, or taking certain medications

Learn more: What causes GERD?

Anyone can develop either LPR, GERD, or both. They’re both common conditions that may affect otherwise healthy people. However, there are some known risk factors.

The conditions share many similar risk factors, including:

To diagnose either GERD or LPR, doctors will usually begin an endoscopy to exclude other causes besides GERD. If they suspect LPR, they may do a laryngoscopy instead. Sometimes, your doctor may refer you to both tests or one after the other, depending on which condition they suspect more.

That said, it’s possible to have a normal endoscopy and still have one of these conditions. Your doctor, usually either a gastroenterologist or a gastroenterologist, might also refer you to a 24-hour pH monitoring test to determine if stomach acid is coming into the esophagus.

For this test, a monitor will be placed in your esophagus and attached to a computer you’ll wear in order to measure the acid coming up from the esophagus and how long it stays.

In some cases, LPR can be symptomless. In these cases, you might not get a diagnosis unless you happen to get a laryngoscopy for another reason.

LPR and GERD are very similar conditions. Because they are both caused by acid traveling up the esophagus, they can both be treated in the same way.

Your doctor will likely first recommend that you make some lifestyle changes. They’ll talk with you about what you eat and what time of day to eat. This might include limiting spicy foods, foods high in fat, and foods high in acid. They might also suggest you lose weight and avoid caffeine, alcohol, and smoking.

Other treatments include over-the-counter medications like:

If OTC medications don’t improve your symptoms, your doctor might prescribe stronger versions.

If this doesn’t help, surgery might be an option. Surgeries for GERD and LPR can strengthen your esophageal sphincter to help prevent acid reflux.

The primary complications of GERD are erosive esophagitis, esophageal stricture, and Barrett’s esophagus. In rare cases, Barett’s esophagus can lead to cancer.

Since GERD and LPR may overlap, LPR can lead to the same complications. In addition, it may also cause:

Occasional acid reflux or heartburn can be managed at home. But GERD is when you experience these symptoms more than twice a week over a long time. GERD and LPR are more serious and should be checked out by a doctor.

Not only will they help you get the treatment you need, but they will also see if there is any damage to your esophagus or throat.

A medical professional can help you prevent further damage. So, it’s a good idea to see a doctor if you’ve been experiencing any symptoms of GERD or LPR for several weeks.

GERD and LPR are both caused by acid reflux. When you have LPR, the acid travels all the way up to your esophagus and into your throat, causing symptoms that are very different from GERD.

Treatment for both conditions is similar and involves lifestyle changes and medications that block acid production.