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Can You Have Acid Reflux Without Heartburn

Remedies For Acid Reflux

Can You Have Reflux Without Heartburn? | Dr. Kevin Ghassemi

Acid reflux can have a few different symptoms depending on diet and severity. Common symptoms are chronic cough, disrupted sleep because of discomfort, heartburn in the chest after eating, or a lump sensation in the throat.

There are few things you can do at home to try to minimize symptoms and avoid acid reflux from occurring all together, though they may not work for everyone.

Avoid Overeating

Because acid reflux is most commonly caused by the food we eat, focusing on your diet can reduce symptoms. Rule number one is to avoid overeating. Research has shown that most symptoms occur after a meal, and that the bigger the meal, the worse the symptoms.

Limit Alcohol Intake

Other studies have linked alcohol consumption with increased stomach acid, leading to increases in acid reflux symptoms, even in healthy individuals. Therefore, limiting the amount of alcohol you consume can help prevent heartburn.

Avoid Acidic Foods and Drinks

In addition to alcohol and overeating, there are other dietary causes of acid reflux that will help you avoid symptoms. Acidic foods that may make heartburn worsen include the following:

  • Citrus fruit juice

What Are The Symptoms Of Gerd And Lpr

The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing. Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath.

While GERD and LPR may occur together, patients can also have GERD alone or LPR alone . If you experience any symptoms on a regular basis , then you may have GERD or LPR. For proper diagnosis and treatment, you should be evaluated by your primary care doctor or an otolaryngologisthead and neck surgeon .

What Causes Acid Reflux

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter . Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldnt, your stomach contents rise back up into the esophagus.

Stomach acids flow back up into the esophagus, causing reflux.

Factors that can lead to this include:

  • Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
  • Particular types of food and eating habits.
  • Medications that include medicines for asthma, high blood pressure and allergies as well as painkillers, sedatives and anti-depressants.
  • A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.

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Other Natural Remedies For Silent Reflux

Once the previous three steps have been implemented, there are a few other options to try if your silent reflux symptoms dont completely resolve.

  • Melatonin may be a surprisingly effective treatment for GERD and LPR. The hormone produced by your body to stimulate sleep may also protect the esophagus from gastric acid and improve strength in the lower esophageal sphincter or LES . Some studies even suggest melatonin may be as effective as a PPI for improving GERD .
  • Sodium Alginate, a supplement derived from brown kelp, acts as a physical barrier between the esophagus and stomach. A systematic review found alginate therapy highly effective for mild GERD .
  • Prokinetic or promotility herbs like the RKT, Iberogast, or STW 5 formulations can help improve colon transit time, allowing your digestion to flow in the correct direction. These herbs may help with heartburn, reflux, and LES function .

What Can Heartburn Be A Sign Of

How to ease acid reflux symptoms

Heartburn is most likely a sign of acid reflux or as its sometimes termed as gastro esophageal reflux disease or GERD for short. People with GERD typically have more chronic and consistent heartburn and acid reflux effects.

The most likely cause of heartburn is something you have drank or eaten or even a medicine you have taken. Some of these things will only make heartburn more likely.

For example, the common trigger foods include spicy food, fatty food, and citrus fruits to name a few. For someone with heartburn likely lowering or eliminating these triggers will help or in some cases completely stop the heartburn from happening. The same can be said for drinks, thinks like soda and alcohol are common heartburn triggers and some medication like anti-inflammatories and anti-biotics can cause heartburn especially if taken longer term.

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Can Acid Reflux Cause Gas

On average, healthy individuals pass gas 13 to 21 times a day. This gas is expelled through the mouth or anus . Gas accumulates in the digestive tract through eating or bacterial fermentation.

As digestive bacteria break down food, little pockets of air are created in the process. Because the bacteria in each human body is different, some people may be more tolerant of digesting certain food compared to other people.

How Are Acid Reflux and Gas Related

Excessive gas and acid reflux may exist simultaneously. A patient experiencing excessive flatulence may also experience bloating from acid reflux. While acid reflux does not directly cause gas, doctors believe that the two may be interlinked.

This is because certain conditions that trigger acid reflux can also trigger gassiness. Individuals who eat spicy and citrusy foods may increase their acidity levels while also triggering gassiness. Alleviating gassiness could coincidentally improve acid reflux symptoms because the circumstances that create these conditions tend to be similar.

Learn more about what food to avoid in this article: What Is the Best Breakfast for Acid Reflux Sufferers?

How Gut Health Affects Silent Reflux

Research shows that your gut health, specifically your microbiome health, may relate to reflux symptoms. One systematic review showed that probiotics seemed to improve the symptoms of GERD, including heartburn, regurgitation, abdominal pain, and gas .

A meta-analysis also found that H. pylori, a bacterium that can infect the stomach and cause ulcers, is present in about half of LPR patients . However, some research shows that H. pylori can actually protect against developing acid reflux or esophageal cancer .

We can tentatively suggest that working to reduce H. pylori and any other gut pathogens as well as supporting the beneficial bacteria in the microbiome with probiotic therapy may help improve LPR or silent reflux symptoms.

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Is Mango Lassi Good For Acid Reflux

Mango Lassi is the most popular summer refreshing drink in India.

A typical Mango Lassi is prepared with A cup of yogurt, 1/2 cup of milk, one cup of ripe chopped Mango, a full spoon of sugar, ice cubes, cardamom.

These are the typical ingredients of mango lassi, and I dont think it is good for acid reflux.

Increased Risk Of Infection

Change GERD/Acid Reflux without medication and stay healthy

As I discussed above, stomach acid serves as a first-line defense against pathogens. The ideal pH for the stomach can approach 1 but should be below 3, where most pathogens cannot survive. When the pH rises above 5, several dangerous bacterial species are able to survive.

Acid-blockers can increase the stomachs pH and worsen the risk of a bacterial infection. In one study, Tagamet and Zantac, two H2 blockers, raised the stomach pH from 12 to 5.5 and 6.5, respectively. PPIs can raise the pH even more. In one study, a 20- or 40-mg dose of Prilosec reduced stomach acid levels to almost zeroand increased the pH to almost 7in 10 healthy men.

Without stomach acid, pathogens can thrive. Oral bacteria such as the genus Rothia are over-represented in the gut microbiota of PPI users, indicating that bacteria entering the through mouth are better able to survive in the stomach.

Compared to people on other medications, PPI users have a greater risk of acquiring infectious bacteria like:

  • Clostridium difficile
  • Dysentery

Small intestinal bacterial overgrowth, or SIBO, is another possible result of PPI usage. SIBO can inhibit nutrient absorption, damage the bowel lining, and cause diarrhea and other GI symptoms. One research study found that 50 percent of PPI users tested positive for SIBO through the hydrogen breath test, compared to only 6 percent of non-users. Meta-analyses have mostly confirmed this association.

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Not All Of Them Are Obvious

Feel like you just cant keep that nasty stuff in your belly from bubbling up into your throat? What youre experiencing might not be run-of-the-mill heartburn. It could be a case of gastroesophageal reflux diseaseGERD, for shorta condition that causes the acid and food in your stomach to rise into your esophagus, and sometimes even enter your mouth or lungs. GERD is far from rare: In fact, it occurs in 20 percent of the U.S. population, according to the medical journal Gastroenterology. But there are also several factors that make some people an easier target for the disease.

Everyone has a small, normal amount of gastroesophageal reflux, but an abnormal amount of acid reflux occurs when the one-way valve between the esophagus and the stomach, called the lower esophageal sphincter, becomes too loose, says Ketan Shah, M.D., gastroenterologist at Saddleback Medical Center in Laguna Hills, California. This can occur for multiple reasons that cause intra-abdominal pressure to be abnormally elevated, including being overweight or obese, frequent overeating, lying down too soon after eating, chronic straining or coughing, or chronic heavy lifting. These are typically the people who are more susceptible to GERD.

Heartburn won’t go away

Bitter taste

Trouble swallowing

Heart Attack Feeling



What Are The Main Symptoms Of Gerd

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

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What Do I Do If I Think I Have Gerd

With GERD when reflux and heartburn happen more than once in a while the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see its affecting your daily eating and sleeping habits.

When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isnt life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.

How Low Stomach Acid Leads To Increased Iap And Gerd

How Should you Sleep if you have Acid Reflux?

Stomach acid is part of the bodys innate immune system, the first line of defense against pathogens. Most bacteria cant survive the stomachs highly acidic environment. If you dont have enough stomach acid, many of the pathogens that would normally be destroyed may survive the stomach and make their way into the rest of the GI tract. This can lead to chronic gut infections, impaired digestion, and an increase in IAP and GERD.

Stomach acid also helps your body absorb many macro- and micronutrients. HCl stimulates the release of pancreatic enzymes and bile into the small intestine to help metabolize carbohydrates and fats. Without enough acid, your body cant digest carbohydrates properly. Those undigested carbs are then fermented by bacteria in a process that generates excess hydrogen gas. Again, that excess gas increases IAP and contributes to GERD.

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Heartburn And Throat Symptoms Not Always Connected

A burning sensation in the chest, and the various throat symptoms of laryngopharyngeal reflux disease are not always intertwined.

Many sufferers of LPRs classic throat related symptoms do not have any heartburn or upper abdominal discomfort.

You can easily have acid reflux in the throat causing symptoms there. All without feeling heartburn.

So the big question is: How do the acidic contents from your stomach bypass the esophagus and settle in the throat?

As Dr. Zinberg had pointed out, you can actually have an inflammatory process going on in the esophagus due to acid reflux and not even know it.

Or, maybe your esophagus is tough enough not to be so readily affected by the stomachs harsh juices but your vocal cords are more sensitive to them resulting in your annoying symptoms.

Thick mucous is produced to coat the throat when stomach acid goes into the larynx area, says Stacey Silvers, MD, in my article titled Trouble Swallowing, Thick Mucus in Back of Throat: Causes, Solutions.

This is why the acidic juices that make their way up the esophagus can lead to symptoms involving the throat and mouth. The absence of heartburn doesnt mean the absence of acid reflux.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.

What Medications Do I Take To Manage The Symptoms Of Gerd

Many over-the-counter and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if youre not getting relief from the OTC formulas.

The most common GERD medications:

  • Antacids include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
  • H-2 receptor blockers include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
  • Proton pump inhibitors include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
  • Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

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Q1 Does Mango Have Uric Acid

Uric acid, gout, and joint inflammation are the most common problems among people, especially those aged 30 to 45 years old.

Those who have Uric acid have to pay attention to their diet, food intake. Mango is safe for uric acid but does not exceed the limit because of Fructose. Tropical fruits, such as mangoes, pears, and apples, typically have higher fructose levels.

Consumption of these fruits on a single occasion or on a regular basis will significantly raise the chance of return of uric acid.

Diagnosis Of Silent Reflux

How To Stop Acid Reflux Permanently Heartburn Relief

At UT Southwestern, our skilled laryngologists conduct a thorough evaluation, which includes a:

  • Physical exam
  • Review of personal medical history
  • Discussion of symptoms

In some cases, we can confirm a diagnosis of LPR based on our evaluation, without any additional testing. Depending on each patients specific needs, we sometimes work with gastroenterologists , who can help to diagnose reflux with pH, impedance, and motility testing.

When needed, additional tests might include:

  • Acid reflux test: Test to measure the amount of acid in the fluid inside the esophagus
  • Endoscopy: Test to view inside the throat and esophagus using a long, thin tube with a lighted camera at its tip
  • Swallowing study: Test to evaluate how food moves from the mouth through the esophagus, using a special liquid called barium that shows up on X-rays

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Symptoms In The Elderly

Elderly patients may not connect their symptoms with heartburn or GERD, as they may be different from what is considered typical for the disease. Usually, when we think of the symptoms of GERD we think of heartburn. In the elderly, symptoms often show up in the mouth, throat, or lungs.

Symptoms that can occur in the throat include:

Elderly patients with some chronic conditions are at a higher risk of developing GERD. They may take medications that cause the LES to relax, which can lead to acid reflux. These individuals also tend to have decreased saliva productionproblematic, as saliva’s alkaline nature can help neutralize acid. Saliva can also relieve heartburn by bathing the esophagus, helping to protect it from the effects of acid that is refluxed and washing it back down to the stomach.

Gerd Symptoms Not Recognized By Most Acid Reflux Sufferers

Gastroesophageal reflux disease, or GERD, can have a variety of symptoms we do not typically associate with acid reflux. GERD is caused by a weakness in the lower esophageal sphincter, the muscular valve that separates the stomach from the esophagus. When functioning properly, the LES opens only to allow food and liquids to enter the stomach. However, a loose LES can allow gastric acid to backflow into the esophagus, and heartburn is only one of many symptoms.

Here are some hidden symptoms of GERD that you might not recognize as being caused by reflux:

  • Hoarse or husky voice A deeper-sounding voice after a meal might mean that you are experiencing reflux of acid into the esophagus or throat.
  • Sore throat GERD can also cause your throat to become sore after eating.
  • Bitter taste A bitter or sour taste in your mouth after eating might be gastric acid from the stomach caused by GERD. In severe cases, acid reflux can cause choking.
  • Asthma Wheezing and coughing can be caused by stomach acid reaching the lungs.
  • Chest pain Heartburn or chest pain can be due to repeated acid reflux.
  • Nausea Feeling queasy after a meal could also point to reflux.
  • Excessive saliva Extra saliva may be produced to wash acid from the esophagus.
  • Bad breath The acidity of reflux can cause bad breath.
  • Difficulty swallowing A feeling of a lump in the throat that wont go away could indicate inflammation of esophageal tissue and strictures.
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    When To See A Gastroenterologist

    Sometimes its difficult to know when your symptoms are severe enough that you need to make an appointment with a gastroenterologist, and we understand that. Here are some indications that its time to call a gastroenterologist:

    • Symptoms that continue for more than two weeks
    • Heartburn that persists after taking over-the-counter medications
    • Heartburn episodes that change in frequency or intensity
    • Nighttime symptoms that affect your sleep quality
    • Acid reflux that interferes with your daily activities or affects your quality of life
    • Unexplained weight loss or decreased appetite
    • Pain or difficulty swallowing
    • Heartburn accompanied by nausea or vomiting
    • Unexplained weight loss
    • Chronic hoarseness or wheezing

    If you experience any of the symptoms above, its time to see one of our gastroenterologists. After performing a complete medical exam, your gastroenterologist may recommend that you undergo an upper endoscopy to evaluate your symptoms and see if you have suffered any damage to your esophagus, or provide you with the peace of mind that everything is all right. During your visit, the doctor will examine the lining of your esophagus, stomach and duodenum to determine the cause of your digestive symptoms and the appropriate treatment.


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