Normally, the things we eat and drink stay in the stomach to be digested and do not spill back up into the oesophagus. However, if the valve at the lower end of the oesophagus (the oesophageal sphincter) is weak then heartburn and reflux may occur. This is when acid passes back up into your upper throat (pharynx) and voice box (larynx), causing the tissue become inflamed resulting hoarseness and sometimes a sensation of a lump in your throat.

This is typically known as laryngo-pharyngeal reflux (LPR), and can occur during the day or at night, even if you haven’t eaten anything. 

It is often referred to as ‘silent reflux’ because many people do not experience any of the classic symptoms of heartburn or indigestion.  However, if even small amounts of reflux come all the way up into the pharynx and larynx, other problems can occur. This is because the tissue lining the larynx and pharynx is more sensitive to injury and irritation from stomach juices than the lining of the oesophagus. Damage to the larynx from stomach refluxate will affect a person’s voice and can sometimes affect their lungs and breathing.