If you’re suffering with nasal congestion, morning sore throat, and a chronic cough, you may think it’s just a cold, the flu, or allergies. But it’s quite possible that you’re wrong, a top expert says.

 “This is the single most misdiagnosed problem in America. People who believe they have allergies probably have acid reflux,” Dr. Jamie Koufman tells Newsmax Health.

The problem, says Koufman, is that most people associate acid reflux with heartburn, when they are much more likely to have respiratory symptoms that mimic the common cold, flu, or allergies.

“Only about 20 percent of people with acid reflux get heartburn, but 80 percent – or 60 million people – develop respiratory symptoms, but they don’t know the true source of their problem,” adds Koufman, founder and director of the Voice Institute of New York, a leading clinic in Manhattan that specializes in voice and reflux treatment

What’s confusing is there are two types of reflux; gastroesophageal reflux disease, or GERD, and “atypical,” or “silent” reflux, which is called “laryngopharyngeal,” reflux, an accepted condition for which Koufman, a pioneer in the field, coined the term.

GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus.

“People with typical GERD have heartburn – chest pain after eating, particularly after eating fried or greasy food,” says Koufman.

On the other hand, with LPR, stomach acid flows back but does not say in the esophagus long enough to irritate it; instead, a small portion comes up in the throat.

“Compared to the esophagus, the throat and voice box are a hundred times more sensitive to irritation from this reflux,” says Koufman, who is also a clinical professor of otorhinolaryngology at the New York Eye & Ear Infirmary at Mt. Sinai in New York City.

But, because most people – and, too often, their doctors – are unfamiliar with LPR, they are misdiagnosed as having allergies. This is all the more confusing because the symptoms of LPR and allergies can overlap.

“Some people have both allergies and LPR, and if your allergies are really bad, the LPR will be as well. Your mucus linings are just waiting for anything that will irritate them,” says Koufman.

Symptoms overlap may overlap with colds or flu as well, but these ailments are self-limiting, Koufman notes.

 “If you get an upper respiratory infection, and then the symptoms linger on for weeks, or even a few months, that’s a tipoff that it’s LPR.”

“LPR can exacerbate existing asthma and sleep-breathing disorders such as obstructive sleep apnea, which is often mistaken for other allergies, sinus or lung disease,” says Koufman.

The disease can also result in scarring of the voice box and windpipe, the results of a faulty lower esophageal sphincter, the muscle that separates the esophagus from the stomach.

Research also shows that chronic LPR, like GERD, increases the risk of esophageal cancer, which is among the deadliest and fastest growing forms of the disease in the U.S.

If you think you have LPR, you should see an otolaryngologist, or ears, nose and throat (ENT) specialist, says Koufman.

LPR symptoms:

• Thick mucus in the throat
• Frequent throat clearing
• Feeling like you have a lump in your throat
• Trouble breathing upon awakening
• Sinus problems
• Chronic cough
• Post-nasal drip
• Heartburn (in 20 percent of cases)

On the other hand, allergies are most notable for these symptoms:

• They are seasonal in nature
• Runny nose
• Itchy eyes
• Overflowing thin mucus

“A tipoff you have allergies is that they start suddenly. For instance, I have allergies, and I know that, when I play a certain golf course, there’s a patch of weeds between the 13^th and 14^th hole. My nose starts to run as soon as I get there, and, by the time I’ve finished 18^th hole, I had finished a pack of tissues,” Koufman says.

According to Koufman’s New York Times bestselling book, “Dropping Acid: The Reflux Diet Cookbook and Cure,” the best treatment for this type of reflux is to follow an anti-acid diet and make lifestyle modifications. 

These foods are best for most people with reflux:

• Oatmeal
• Brocolli
• Bananas
• Melon
• Whole grain
• Fish, but not fried
• Baked or grilled chicken, no skin
• Alkaline water

Tips on following an anti-acid (or alkaline) diet:

• Avoid fatty foods
• Cut out sugar
• Most fruits are acidic, although melon and banana are good for most people with reflux.
• Don’t eat tomatoes or onions
• Eliminate foods with gluten, including breads
• Don’t drink grapefruit or orange juice
• Avoid all carbonated beverages
• Don’t eat chocolate
• Limit caffeine
• Use salad dressings, or condiments like mayonnaise very sparingly
• Don’t use canned or processed foods; federal law mandates that food manufacturers acidify them as a preservative.

These lifestyle modifications are also important:

• Lose weight
• Eat small meals
• Don’t eat anything after 8 p.m.
• Cut out alcohol
• Sleep on a 45-degree incline
• Don’t smoke or use tobacco products

Medications known as H2 blockers, like Tagamet, Pepcid, and Zantac, can be helpful to some people with LPN, but Koufman does not recommend the use of proton pump inhibitors (PPIs), a popular class of drugs that includes Prilosec and Prevacid.

 PPI’s are generally ineffective against LPN, says Koufman.  They have also been linked with life-threatening diseases, and a study, published in July, reported that people using them had a 25 percent higher death rate than those taking other types of heartburn drugs.

 “Most cases of LPN can be cured with diet and lifestyle modifications,” says Koufman.