Post by @mollypelletier.rd

When you find out your constant throat clearing isn't allergies, it's pepsin. Pepsin is a digestive enzyme made in your stomach. When you reflux, it can travel up and stick to the delicate tissue of your throat and voice box. This is laryngopharyngeal reflux (LPR), also called silent reflux, because it often comes with no heartburn at all. You get throat clearing, hoarseness, a lump-in-the-throat feeling, post-nasal drip, or a nagging cough instead, which is why so many people treat it as allergies for years. Pepsin also doesn't need much acid to irritate your throat. In a Yale lab study on human throat cells, pepsin got into the cells and switched on inflammatory signaling, and the effect was stronger at a neutral pH than an acidic one. Antihistamines don't address any of this. Acid blockers lower the acid, but they don't stop reflux from reaching your throat, so the pepsin still gets there. Here's what I teach my clients to keep pepsin away from the throat: The 3-Hour Buffer: stop eating 3 hours before bed (drinks are fine). Lying down on a full stomach makes it easier for reflux to reach your throat overnight. The LES Lock: 1 to 5 minutes of diaphragmatic breathing right after meals, up to 5 times a day, letting your rib cage expand 360 degrees (front, sides, and back). This trains the part of your diaphragm that wraps around your lower esophageal sphincter (LES), so fewer reflux events make it up in the first place. Swap the throat clear: every clear slams your vocal folds together and irritates the tissue more. Sip water or do a gentle swallow instead. If hoarseness lasts more than a few weeks, see an ENT so other causes can be ruled out. The full step-by-step plan is in the FLORA App, link in my bio. 📚 Doukas et al., 2021, Int J Mol Sci, in vitro study of human hypopharyngeal (throat) cells, pepsin tested at pH 5.0, 6.0, and 7.0, PMID: 33924087. Halland et al., 2021, Am J Gastroenterol, RCT, n=33, post-meal reflux events 2.60 to 0.36 with diaphragmatic breathing, PMID: 33009052. #LPR #silentreflux #throatclearing #acidreflux #refluxdietitian