@mollypelletier.rd: When you find out that your constant throat clearing isn't allergies, it's pepsin. Here's the mechanism, because this one gets missed for years. Pepsin is a digestive enzyme made in your stomach. When you reflux, it can travel up with the refluxate and attach to the delicate tissue in your throat and voice box. This is laryngopharyngeal reflux (LPR), and it shows up as throat clearing, hoarseness, a lump-in-the-throat feeling, post-nasal drip, and a nagging cough. So many people chase allergies for years because it often comes with no classic heartburn at all. Silent reflux earns its name. The part most people miss: pepsin can keep irritating your throat even when the reflux isn't acidic. In a Yale lab study on human throat cells (Doukas et al., Int J Mol Sci 2021, PMID 33924087), pepsin stayed active and triggered inflammatory, cell-damaging signaling even at a neutral, non-acidic pH of 7.0. That's why antihistamines, and sometimes even acid blockers, leave you still clearing your throat. The enzyme is the actor, and it doesn't need much acid to do damage. Here's what I teach my clients to lower pepsin exposure at the throat: 1. The 3-Hour Buffer: stop eating 3 hours before bed (beverages are fine). Lying down on a full stomach is prime time for reflux to reach your throat overnight. 2. The LES Lock: 1 to 5 minutes of diaphragmatic breathing with full 360 ribcage expansion immediately after meals, up to 5x daily. This strengthens the crural diaphragm that wraps your lower esophageal sphincter, so fewer reflux events travel up in the first place. 3. Break the throat-clear loop: clearing slams your vocal folds together and irritates the tissue more. Sip water or do a gentle, quiet swallow instead. Save this if you've been told it's just allergies. Follow for more reflux science that explains the why, and check the link in bio for more support. #acidreflux #lpr #silentreflux #throatclearing #refluxrelief

Molly | The Reflux Dietitian

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Friday 19 June 2026 21:17:42 GMT