Acid reflux may not cause heartburn.
For many people, acid reflux is heralded by heartburn or regurgitation. Heartburn is usually described as a heavy, burning sensation behind your breastbone, while regurgitation is characterized by stomach contents rising into your throat or mouth. It is possible, however, for acid reflux to manifest with вЂњextra-esophagealвЂќ symptoms, such as a chronic cough, wheezing or sore throat. And acid reflux may occur without triggering any symptoms at all.
Some Reflux Is Normal
Whenever you swallow food or fluids, muscular contractions in your esophagus push the material from your throat to your stomach. The material is kept there by the lower esophageal sphincter, or LES, a valve-like area between your esophagus and stomach. However, the LES normally permits a small amount of gastroesophageal reflux. According to a 2012 review in the вЂњInternational Journal of Dentistry,вЂќ this physiologic reflux is neutralized by chemicals in your saliva and is rapidly cleared away by esophageal contractions.
GER versus GERD
Physiologic gastroesophageal reflux, or GER, typically occurs after meals and does not usually trigger symptoms in healthy people. However, for 10 to 20 percent of the American population, GER progresses to a syndrome called gastroesophageal reflux disease when the reflux of stomach contents creates complications. For some people, GERD is characterized by daily heartburn. For others, GERD may not cause heartburn but could trigger symptoms, such as chest pain or cough, that might initially be attributed to other conditions.
Just because you don't have heartburn does not necessarily mean you don't have acid reflux. According to a 2003 review in вЂњAmerican Family Physician,вЂќ only 2 to 3 percent of acid reflux events are perceived by people who have GERD. вЂњSilentвЂќ acid reflux has been linked to chronic cough, persistent hoarseness, sore throat, eroded dental enamel, asthma, esophageal scarring and ear and sinus problems. Even some patients with GERD-related esophageal cancer do not complain of heartburn.
GER and GERD represent two points on a spectrum of acid reflux. GER is a normal phenomenon that usually does not cause symptoms and may not be evident to you or your physician. By definition, GERD causes persistent or recurrent symptoms -- usually heartburn or regurgitation -- or some other problem that eventually becomes evident, such as swallowing problems or eroded dental enamel. GERD usually responds to medications and lifestyle changes, such as weight loss, dietary modifications or smoking cessation. If you have GERD, your doctor will guide your evaluation and treatment.