You’ve tried inhalers. You’ve followed your asthma action plan. Maybe you even gave up spicy food, dairy, and started sleeping with your head elevated. But your chronic cough or asthma still won’t quit.
What if the real issue isn't your lungs... but your esophagus?
Surprise: silent reflux (also called laryngopharyngeal reflux or non-acid reflux) could be the hidden culprit behind your lingering respiratory symptoms.
What Is Silent Reflux—and How Can It Trigger Asthma or Chronic Cough?
Unlike classic GERD, silent reflux doesn’t always cause heartburn. That’s what makes it tricky. The stomach contents may still move upward into the esophagus (and even the throat), irritating the airway and triggering symptoms like:
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Chronic dry cough
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Wheezing or shortness of breath
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Hoarseness or throat clearing
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Symptoms that worsen when lying down or after meals
This is especially frustrating for patients who are already managing asthma or allergies and feel like they’re doing everything right.
Learn more about how allergies and asthma are connected on our Asthma & Allergies page.
How Do We Test for Silent Reflux?
When standard treatments aren't working and GERD is suspected, we use two specialized tests to uncover the root cause:
1. Esophageal Manometry
This test measures how well the muscles of your esophagus are working. A thin, flexible tube is passed through your nose into your esophagus to:
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Record muscle contractions when you swallow
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Locate the lower esophageal sphincter (LES), the “gatekeeper” that prevents reflux
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Prepare for accurate placement of the next test
It’s quick, safe, and essential before pH testing.
2. 24-Hour pH-Impedance Monitoring
This is where we track reflux episodes over a full day—even the ones you can’t feel.
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A catheter stays in place for 24 hours and monitors both acidic and non-acidic reflux.
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You’ll carry a small recorder and press a button when you experience symptoms like coughing or tightness.
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This helps us match symptoms to reflux events and assess the impact of silent GERD.
Don’t worry—it’s not painful, though some people describe it as “a little annoying.” But for many patients, it’s completely worth it to finally connect the dots.
Important information for People with Asthma
Reflux doesn’t just irritate the esophagus—it can also trigger airway inflammation and bronchospasm, making asthma harder to control. Even a small amount of reflux reaching the upper airway can activate reflexes that cause coughing or wheezing.
According to the American College of Gastroenterology, reflux-related symptoms are common even without typical heartburn, especially in patients with chronic respiratory complaints.
If you’ve been battling chronic cough or difficult-to-control asthma with no clear answer, silent reflux might be the missing piece.
Esophageal manometry and pH monitoring aren’t just tests—they’re tools that help us personalize your treatment and get your symptoms under control for good.
Talk to your doctor about whether reflux testing might be appropriate in your case. And if you're managing both asthma and allergies, make sure you're addressing all possible triggers.
This article is for educational purposes only. Always consult your healthcare provider for personalized medical advice.