Q: I’m told I have acid reflux, but how can that be if I don’t have heartburn?
A: It is possible to have an MI (heart attack) without any chest pain. In the same way, it is possible to have acid reflux up the esophagus without any heartburn. Beyond this, even if acid comes up into the throat at night, this may not waken you unless it is major. Think of gentle-to-moderate rain in the night as an analogy. If you do have the nighttime reflux, however, you may notice symptoms such as a dry or scratchy/sore throat, increased mucus production with throat clearing, a deep morning voice requiring more warmup if you must sing early in the day. The potential for “silent” reflux explains why physicians may suggest a treatment trial even when you have no awareness of actual acid either during the day, or at night.