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Pauline Guillouche (gastroenterologist)
Do you regularly have a hoarse voice, a slight cough or a constant need to clear your throat? You may be suffering from a type of reflux, called “silent reflux.” Explanations from Pauline Guillouche, gastroenterologist.
Chronic cough, constant need to clear your throat, hoarse voice… If these symptoms are familiar to you, you may be suffering from “silent reflux”. What does this pathology consist of? Explanations from Dr Pauline Guillouche, gastroenterologist.
A diagnosis of gastroesophageal reflux, sometimes wrongly made
“There are many patients who suffer from this type of problem.” first explains the specialist. “They generally go to see their doctor, to whom they complain of this unpleasant feeling, with a constant need to clear their throat“.
This frequent reason for consultation, when it is not resolved by the general practitioner, will lead the patient to a specialist. “Sometimes, when the general practitioner fails to relieve his patient, when he has ruled out simple causes such as angina or otitis, he redirects him to an ENT specialist. There, by looking at the bottom of the throat, often reddish, he will deduce the presence of a “silent reflux” vs“i.e. gastroesophageal reflux which does not present any noisy symptoms: no pain or burning sensation, increased when lying down or when leaning forward”.
“Silent reflux” is a functional pathology
In reality, for the gastroenterologist, if a gastric fibroscopy and a pHmetry are carried out, the diagnosis of gastroesophageal reflux will ultimately be ruled out, in the vast majority of cases, for these patients. But problem: they are still often treated for this.
“This observation of redness in the pharynx sometimes pushes ENT specialists to put patients on high-dose antacid medication. Sometimes in some patients the symptoms disappear, but this is due to chance, the placebo effect or it simply disappears, unrelated to the treatment. We find patients who follow this treatment for many months, for no reason, because the presence of real reflux without typical symptoms is ultimately very rare..
For the specialist, this type of manifestation does not hide a pathology. “This is what we call a functional pathology, it is due to a discharge in the back of the throat, in winter, for example. It can even be a behavioral tic” she concludes.