MS, RD The Reflux Dietitian

PSA: chronic cough and excessive post-nasal drip after eating are signs of silent reflux. And in 2026, you are still most likely being handed a PPI for it. Here's what the research says about that. In the largest placebo-controlled trial of a PPI for reflux-related throat symptoms (Vaezi et al. 2006, a multicenter randomized trial in the Laryngoscope, PMID 16467715), the main symptom resolved in under 15% of patients on esomeprazole twice a day for 16 weeks. The placebo group did exactly the same. It gets stranger. A 2026 systematic review on the global burden of LPR (Lechien and Maniaci, European Archives of Oto-Rhino-Laryngology, PMID 42543424) found there is still no ICD-10-CM diagnostic code for laryngopharyngeal reflux, and that empiric PPI use "despite evidence of limited effectiveness in non-acid reflux" is driving unnecessary healthcare costs. There is no billing code for the thing you have. So if you have LPR right now, you have to be your own advocate. Here are the first 5 things I'd do if I was diagnosed with LPR: A temporary low-acid healing phase. Pepsin, the enzyme that travels with refluxate, sticks to your throat tissue and switches back on every time acid hits it. It's most active around pH 2 and inactive above pH 6.5, but it survives at neutral pH and reactivates when re-acidified (Johnston et al. 2007, Laryngoscope, PMID 17417109). A low-acid phase gives that tissue a window without reactivation. Temporary is the key word. This is a healing phase, not a forever list. The 3-Hour Buffer. No food in the 3 hours before lying down. Drinks are fine. Less volume and pressure against your LES overnight means less refluxate reaching your throat while you sleep. Daily nervous system support. What I teach clients is the Nervous System Snack: 1 to 5 minutes of extended exhales or diaphragmatic breathing, 1 to 3 times a day. Fight or flight pulls blood flow away from your gut and tightens your diaphragm. Rest and digest is where the anti-reflux barrier actually does its job. Mealtime Mindfulness. Chew to an applesauce consistency, phone away, no rushing. Chewing alone stimulates 30 to 50% of your digestive juice production, which keeps things moving down instead of up. If you need more support, get a personalized plan. This is exactly what our team maps out with clients, and it's the fastest way to stop guessing. Check the link in bio for the details. Please talk with your doctor before changing any medication. You deserve support that actually explains why. Follow for more and share this with someone who's been clearing their throat all year. #LPR #SilentReflux #AcidReflux #ChronicCough #RefluxRelief