By the way, doctor: What causes acid reflux in the throat?
Q. I developed a hoarse voice and annoying phlegm in my throat and was surprised to learn that the cause was acid reflux. I've never had heartburn, so I don't know how this could have happened. Can you explain what causes acid reflux?
A. It sounds as though you have a condition called laryngopharyngeal reflux (LPR). This occurs when stomach contents, including acid and enzymes, back up into the esophagus and injure the tissues of the larynx (voice box) and pharynx (throat). The cause is malfunctioning of the upper and lower esophageal sphincter muscles. These muscles are supposed to keep food moving in the right direction, from mouth to stomach. The lower esophageal sphincter prevents stomach acid from moving up the esophagus. When it malfunctions, stomach acid irritates the esophageal tissue immediately above the stomach, causing symptoms such as heartburn and chest pain with swallowing. This condition is called gastroesophageal reflux (GERD).