In fact, half of the people who have LPR never have heartburn at all. This is because the material that refluxes does not stay in the esophagus for very long. In other words, the acid does not have enough time to irritate the esophagus. However, if even small amounts of refluxate comes all of the way up into the throat, other problems can occur. This is because, compared to the esophagus, the voice box and throat are much more sensitive to injury and irritation from stomach acid.
Some people do have heartburn, too.
Some people have hoarseness that comes and goes, and others have a problem with too much nose and throat drainage, that is, too much mucus or phlegm. If your doctor thinks that you could have LPR, he or she will probably perform a throat examination first and look at the voice box and the lower throat. At that point, your doctor may order some tests or recommend specific treatment. If your doctor orders tests, this is to be sure about your diagnosis, to make sure that you don't have any complications of LPR, and to help pick the best type of treatment for you. The two most common tests for LPR are pH monitoring, also called pH-metry, and a barium swallow.