No, there can frequently be reflux in the absence of heartburn. In many cases the reflux occurs at nighttime when we lie down. While horizontal, the stomach contents can more easily pass backwards up the esophagus. Other individuals may simply not experience heartburn even though reflux is present. Reflux laryngitis can be diagnosed using a combination of the medical history, findings on physical examination, and various diagnostic tests.
Physical examination requires a careful examination of the larynx.
The most common site of inflammation is the back of the larynx. This is the first site where refluxed acid comes in contact with the throat. The lining of the throat becomes inflamed, which is seen as increased redness and swelling. The vocal folds themselves may also be swollen. Several diagnostic tests can assist in the diagnosis of reflux.