Reflux doesn’t always present as heartburn. In laryngopharyngeal reflux (LPR), both acid and non-acid components of stomach contents — including pepsin and bile — can reach the throat, airway, and upper digestive tract. This leads to a pattern of non-classic GERD symptoms that are frequently mistaken for ENT, dental, pulmonary, or allergy conditions. Common LPR-associated symptoms include: • Ear fullness or ringing • Dental enamel erosion without cavities • Persistent lump in the throat (globus)

Heartburn isn’t the only reflux symptom. In fact, you can have severe reflux and never have heartburn a day in your life. Here’s what you need to know: a type of reflux Laryngopharyngeal Reflux (LPR) often doesn’t involve heartburn usually. It isn’t just about acid reflux reaching the throat. While stomach acid traveling up (proximal reflux) can irritate the throat, LPR can also be pepsin-mediated. Pepsin is a digestive enzyme that can damage throat tissues even when acid levels are low or absen