Friday, April 12, 2024

Can You Have Acid Reflux Without Heartburn

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Change The Way You Eat:

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

Feed your body in a way that support healthy digestion. This includes:

  • Eat smaller portions. Its important to eat only as much as we can digest. Overfeeding even good bacteria causes gases and bloating.
  • Eat at consistent intervals. Setting a routine helps to decrease stress caused by blood sugar fluctuations and unpredictability.
  • Slow down to eat. Take time to sit, chew, set aside other tasks, and enjoy a relaxed mealall of which send the right signals to our bodies to digest.
  • Breath. Deep breaths between bites of food and throughout the day can help mitigate acid reflux associated with a hiatal hernia.
  • Incorporate protein into each meal. The protein trick is something I learned for my own body many years ago. Include 5 to 10 grams of protein in each meal to ensure that you have enough protein signal to the esophageal sphincter to close.
  • Eliminate trouble foods from your diet. Either follow an elimination diet, or do a food panel and eliminate the foods that come back high. For bloating, you may need to pay special attention to FODMAP foods. And for histamine issues, eliminate foods that trigger histamine.

Can Acid Reflux Cause Dizziness

Dizziness and acid reflux are rarely associated with each other. However, personal accounts show that acid reflux, specifically GERD can also lead to dizziness in patients. This dizziness is often characterized as lightheadedness, weakness, and a temporarily blurry vision.

Dizziness and Acid Reflux: Is There a Link?

While dizziness is not often listed as a common symptom of acid reflux, a study suggests that there is a link between peripheral vertigo and acid reflux.

Scientists suggest that patients who experience dizziness alongside their acid reflux may be due to gastric acids irritating the ear, which could lead to ear infections.

The study reported that 77.6% of patients with peripheral vertigo were also diagnosed with acid reflux compared to 26% of patients without reflux symptoms.

Although further studies are required to finalize the findings, the researchers suggest that reflux contents such as Hydrochloric acid and pepsin could get into the middle ear through the Eustachian tube and affect the ear directly. This can cause tinnitus or a perceived ringing of the ears.

Another way acid reflux could cause dizziness is through bacterial infection. The bacteria Helicobacter pylori can travel further up the esophagus through reflux contents and reach the upper respiratory tract. This could cause scarred ear drum , leading to dizziness.

Learn more: Can Acid Reflux Cause Sinus and Ear Problems?

Diet And Lifestyle Changes For Silent Reflux

Treating silent reflux or LPR starts with modifying your diet and lifestyle.

If you have silent reflux or symptoms of LPR, you probably already know that eating certain foods or overeating can trigger symptoms. If you havent identified your food triggers yet, a simple elimination diet can help. It will also remove other inflammatory foods from your diet.

Common triggering foods include:

Which diet should you start with? Its usually best to start with a Paleo diet for 2-3 weeks, monitoring your symptoms. The Paleo diet is a simple, anti-inflammatory option that is not overly restrictive and provides relief for many people.

If symptoms dont improve, you can move on to a more specialized diet like low FODMAP or low histamine. Give any new dietary changes a few weeks before reevaluating your symptoms. Some people experience relief right away, but others need time to adjust to the new dietary pattern.

However, if the new diet is helping, continue it while you address other underlying issues, including imbalances in the gut. Once underlying imbalances have been improved, you can begin to gradually reintroduce healthy foods that have been eliminated, monitoring your symptoms to see what your body tolerates and what seems to trigger symptoms.

Other eating and lifestyle habits may also help to control silent reflux:

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Is It Heartburn Several Conditions Can Be Mistaken For Acid Reflux

Heart Disease


Stomach Ulcers

Hiatal Hernias and Esophageal Cancer

Gastroparesis and Esophagitis

Gastroparesis and esophagitis are known causes of heartburn. Nerve damage related to diabetes can affect the digestive tract and can cause food to move slowly through the digestive system. This can result in heartburn due to gastroparesis. Esophagitis occurs due to frequent acid reflux. Taking pain killers or osteoporosis medications without water can cause them to remain in the esophagus, resulting in inflammation. Inflammation can also be caused by certain infections or radiation. Esophagitis can also be related to allergies and asthma.

Talk to your doctor if you are experiencing the symptoms of heartburn, as it could be something more serious. Treating chronic heartburn can improve your long-term gastrointestinal health!

Gerd Without Heartburn It’s Possible

Can You Have Acid Reflux without Heartburn?

When you think about gastroesophageal reflux disease , you think heartburn. And yes, that’s a classic symptom of reflux, but you can have reflux disease without having heartburn symptoms.

Reflux can affect the larynx and throat, too, not just the esophagus. When that happens, it’s called laryngopharyngeal reflux , and may not cause heartburn. Instead, you may experience symptoms such as hoarseness, post-nasal drip, and sore throat.

“Reflux takes different forms, and when you have the condition without heartburn, it’s called ‘silent reflux,'” says Jamie Koufman, MD, director of The Voice Institute of New York and co-author of Dropping Acid: The Reflux Diet Cookbook and Cure.

While GERD is sometimes the result of a weak or faulty lower esophageal sphincter , LPRD can be the result of a weak or faulty upper esophageal sphincter . That’s the valve at the junction of the throat and esophagus. “If the upper valve fails, it can be pretty serious,” says Kaufman.

That’s because we don’t just reflux stomach acid. We also reflux an enzyme called pepsin. “Imagine pepsin as little lobsters that, once refluxed, can attach themselves to the lining of the throat,” explains Koufman. “Once they’ve taken up residence, acid from ingested foodnot just from the stomachcan activate the enzyme and cause damage to the throat.”

So, how do you know if you have silent reflux? Take Dr. Koufman’s quiz below.

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Find Out How Acid Reflux Can Cause Throat Symptoms Without Causing Heartburn

Yes, indeed, its possible for acid reflux to make its way into the throat and cause its typical throat symptoms such as cough, without causing any heartburn or chest discomfort.

Not everyone feels esophagitis, even if present, says Jonathan Zinberg, MD, chief of gastroenterology at South Nassau Communities Hospital, Oceanside, NY.

Occasionally there are no significant findings in the esophagus and only in the throat, adds Dr. Zinberg.

Perhaps their esophagus is more resistant than most. Sometimes what looks to the ENT doctor like reflux-induced changes actually are not.

Arent Gerd & Lpr The Same Thing

“My GI doctor tells me that I dont have reflux. Why are you still treating me with reflux medicines?”

As surprising as it may sound, GERD and LPR are not quite the same thing. Although they are both related to refluxing stomach acid, they can be caused by different amounts and types of reflux, and they cause different symptoms. It is possible to have LPR without having GERD, and it is also possible to have GERD without LPR. That is why your otolaryngologist may recommend treatment with reflux medications even though a gastroenterologist may have told you that it is not necessary.

If you are experiencing the symptoms of LPR, you should consider an evaluation at the Temple Voice, Airway & Swallowing Center. For more information or to schedule an appointment, call 844-570-1767.

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Lower Esophageal Sphincter Problem

The thing that basically always plays an important factor in heartburn and GERD is the lower esophageal sphincter . If you didnt know the LES is the valve above the stomach which is designed to open when you eat and drink. When you are not eating or drinking the LES is meant to close over to keep the acid inside the stomach as its meant to be.

The problems arise when the LES doesnt close. There are a lot of potential reasons that they LES might not close properly. Though if it doesnt close properly this is what can lead to the heartburn, indigestion, and chest pain even when you havent eaten.

There are countless things that can cause the LES to malfunction, its uncommon to be solely related to a direct LES malfunction. This is because it has often been caused by another factor like the diet and medication I mentioned already.

To mention another couple of reasons the LES can malfunction one is simply overeating. When I say overeating, I mean eating too much in one sitting.

Basically, when you eat too much like this puts more pressure on the stomach and this can lead to LES opening up due to this increased pressure. This repeated process over several years can weaken the LES over time which then can sometimes lead to the LES malfunctioning and not closing properly as it should.

This in turn leads to heartburn and acid reflux symptoms. Sometimes for certain people simply loosing some weight around this area can completely stop heartburn and acid reflux symptoms.

Can Acid Reflux Cause Nerve Pain

How to Treat Acid Reflux without Medicines | DOTV

Acid reflux symptoms can be typical or atypical in nature. Tingling limbs and nerve pain are considered rare and atypical acid reflux symptoms.

Dr. Mark Babyatsky, a former department chairman at Mount Sinai School of Medicine in New York, explained that inflammation from acid reflux can reach the lungs and trigger pneumonia.

As a result, the diaphragm can become inflamed, affecting the phrenic nerve, which is a nerve connecting the neck, lung, heart, and diaphragm. In this scenario, a patient can feel referred pain in the limbs, specifically the arms and shoulders.

Alternatively, nerve-related issues may be caused by pre-existing neuropathic conditions, leading to acid reflux. An example of this is gastroparesis. Gastroparesis is a form of diabetic peripheral neuropathy characterized by slow digestion. This leads to bloating, heartburn, and vomiting of undigested food.

If youre experiencing acid reflux symptoms with nerve pain, theres a high chance that your nerve pain is not reflux-related, especially if you are experiencing temporary reflux. Get in touch with a medical professional to find a separate diagnosis concerning your nerve pain.

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Heartburn And Gerd In Pregnant Women

Heartburn and GERD are commonly associated with pregnancy and can occur in women who may never have had GERD symptoms before. Pregnant women usually experience GERD symptoms around the first trimester. It then worsens in the last trimester. The good news is that when your baby is born, your symptoms usually go away.

Pregnancy can increase levels of the hormone progesterone, which can cause the muscles of the lower esophagus to relax. This makes it more likely that acid will reflux. Increased pressure on the stomach from a growing uterus can also increase a womans likelihood for having GERD.

Symptoms include pain that gets worse after a meal and acid regurgitation. Because the symptoms tend to be temporary, a woman usually doesnt experience the long-term complications associated with GERD, like ongoing inflammation.

Doctors usually avoid prescribing too many medications while a woman is pregnant because the medicine can be passed along to the fetus. Instead, doctors usually recommend making lifestyle changes, such as avoiding foods known to cause acid reflux and sleeping with the head slightly elevated. Taking antacids that contain magnesium, aluminum, and calcium may be permitted. However, antacids with sodium bicarbonate should be avoided in pregnant women because they can affect a womans fluid volumes.

Symptoms Of Silent Reflux

  • Trouble breathing
  • Sore throat

When stomach acid pools in the throat and larynx, it can cause long-term irritation and damage. In adults, silent reflux can scar the throat and voice box. It can also increase risk for cancer in the area, affect the lungs, and may aggravate conditions such as asthma, emphysema or bronchitis. Because silent reflux symptoms affect the larynx rather than the esophagus, as with GERD, it is harder to diagnose and may go untreated. A doctor can diagnose silent reflux by performing specialized tests.

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Can Acid Reflux Cause Chest Pain

Chest pain is one of the most common symptoms of acid reflux. Chest pain related to reflux is also called noncardiac chest pain . Chest pain occurs during reflux episodes because the heart and the esophagus share a nerve network. Acid reflux, specifically GERD, causes up to 66% of reported NCCPs.

Evaluating Your Chest Pain

Since chest pain from acid reflux and more serious conditions such as heart attack are hard to distinguish, its important to know how to evaluate your chest pain. Chest pain from acid reflux often affects the sternum or the area below it called the epigastrium. Pain from acid reflux is often characterized as a sharp pain, which gets worse with coughing.

Meanwhile, chest pain from non-acid reflux sources could be described as a deep, searing pain. Heart-related chest pain often radiates to other parts of the body including the back, neck, shoulders, and arms.

The symptoms that accompany chest pain are also key in evaluating the nature of the pain. Gastro-related chest pain is often accompanied by burping or flatulence, trouble swallowing, bile regurgitation, and a burning sensation in the throat or stomach.

Cardiac-related chest pain is often accompanied by numbness in the left arm or shoulder, shortness of breath, dizziness, and high body temperatures.

Why Do I Have Acid Reflux On An Empty Stomach


There are multiple reasons why you can get acid reflux on an empty stomach. The most probable causes are either from past effects of irritating the stomach and digestive tract before due to things like eating/drinking things that can worsen acid reflux like spicy food, fatty food and soda to name a few. Also, things like overeating can worsen symptoms because it puts more pressure on the valve above the stomach known as the LES. When this valve has been weakened this makes acid reflux all the more likely even when you havent eaten.

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Identifying Gluten And Other Food Sensitivities

While it is possible to test for Celiac disease with a biopsy during an endoscopy, youll need to specifically ask for this test because it is not done automatically. Plus, the biopsy result will not be able to identify gluten sensitivity which is much more common than Celiac disease.

Celiac disease is an autoimmune condition and is much rarer than gluten sensitivity . The treatment for both Celiac disease and gluten sensitivity is to avoid gluten.

If you are wondering whether gluten is an issue for you whether it is an underlying cause of heartburn, bloating, and other digestive symptoms then you can find out in one of two ways:

  • Go on an elimination diet: Avoid gluten for 3 weeks, then add gluten and the other foods back in one by one and note any symptoms that increase as you do so.
  • Do a food sensitivity panel that checks for IgA and IgG antibodies to gluten, gluten-containing grains, and other common food allergens, such as dairy products , and eggs.
  • It is important to know that your standard doctor or allergist will not run an IgA and IgG panel. They only check of IgE reactions, which are immediate responses to foods. While it is important to know whether you have a classic food allergy, that wont tell you whether you also have a delayed food sensitivity.

    There are many food sensitivity panels available, however, I want to make sure you know about the best IgA and IgG panels based on my 20 years of experience.

    How Is Gerd Treated

    Treatment for GERD depends on how severe symptoms are. For some people, treatment may just include lifestyle changes, such as changing what they eat or drink. Others will need to take medicines. In very rare cases, when GERD is particularly severe, a doctor will recommend surgery.

    These lifestyle changes can help ease the symptoms of GERD or even prevent the condition:

    • quitting smoking
    • avoiding carbonated beverages
    • avoiding foods that trigger reflux

    It also can help to not lie down for 3 hours after a meal and to not eat 2 to 3 hours before going to bed. Doctors sometimes also recommend raising the head of the bed about 6 to 8 inches. Before you start a major bedroom makeover, though, talk to your doctor and your parents about the best sleeping position for you.

    If symptoms continue, doctors might prescribe medicine, such as:

    • H2 blockers, which can help block the production of stomach acid
    • proton pump inhibitors, which reduce the amount of acid the stomach makes
    • prokinetics, which help the esophageal sphincter work better and the stomach empty faster. This can prevent reflux episodes.

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    The Difference In Their Symptoms

    Both acid reflux and gastroesophageal reflux disease have many similar symptoms. You say heartburn, we say acid reflux.

    Its pretty clear when you have simple heartburn. Theres a burning in your chest that might have been caused by poor digestion since you sat in your lazy boy chair right after dinner.

    With acid reflux and GERD there are additional and very uncomfortable symptoms. Pain and pressure in your chest especially when lying down is one obvious symptom. Add in that bitter and sour taste in your mouth because the food you ate is regurgitating back into your throat.

    This keeps occurring because the esophagus and stomach are connected by the LES, better known as the lower esophageal sphincter. It should close once the food reaches the stomach, but sometimes it is weakened or just does not close securely to keep the food down. When someone occasionally experiences these symptoms, they are suffering from acid reflux.

    How Are Gerd And Lpr Diagnosed And Treated

    How to fix acid reflux( heartburn) without medication??

    GERD and LPR can be diagnosed or evaluated by a physical examination and the patients response to a trial of treatment with medication. Other tests that may be needed include an endoscopic examination , biopsy, x-ray, examination of the esophagus, 24-hour pH probe with or without impedance testing, esophageal motility testing , and emptying studies of the stomach. Endoscopic examination, biopsy, and x-ray may be performed as an outpatient or in a hospital setting. Endoscopic examinations can often be performed in your ENTs office, or may require some form of sedation and occasionally anesthesia. Most people with GERD or LPR respond favorably to a combination of lifestyle changes and medication. Medications that could be prescribed include antacids, histamine antagonists, proton pump inhibitors, pro-motility drugs, and foam barrier medications. Some of these products are now available over the counter and do not require a prescription. Children and adults who fail medical treatment or have anatomical abnormalities may require surgical intervention. Such treatment includes fundoplication, a procedure where a part of the stomach is wrapped around the lower esophagus to tighten the LES, and endoscopy, where hand stitches or a laser are used to make the LES tighter.

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