Mechanisms Preventing Pharyngeal Reflux

Eligibility Criteria

• * Age 18 to 85
• * GERD patients with complaints of regurgitation and supra-esophageal symptoms will be included and recruited from our GI \& Otolaryngology clinics
• * GERD patients without complaint of supra-esophageal symptoms and regurgitation will be included and recruited from our GI \& Otolaryngology clinics
• * Asthma patients with and without supra-esophageal symptoms will be included and recruited from clinics affiliated with Medical College of Wisconsin. Asthma patients with the following classifications of asthma severity will be included: intermittent, mild persistent, moderate persistent, and severe persistent (as long as no acute asthma exacerbation at the time of the study)
• * Patient definition will be based on position statement and technical reviews of the American Gastroenterological Association and Montreal definition and classification of gastroesophageal and reflux disease (Am J Gastroenterol. 2006;101:1900-1920).
• * SERD is defined as patients on long term acid suppressive therapy complaining of persistent regurgitation along with supra-esophageal manifestations such as burning throat, asthma, chronic cough, or hoarseness. Patients will be screened by Reflux Symptom Index \> 13.
• * Barrett's esophagus patients will be recruited based on histological diagnosis from previous endoscopic biopsy that will be found using the clinical database warehouse.
• * Age \<18 or \>85
• * Active alcohol or drug abuse
• * History of ear, nose, throat and pulmonary diseases suspected of being GERD induced
• * History of head and neck malignancy and chemo-radiation therapy to the head and neck
• * Unable to give consent
• * Pregnant women (see justification in the Women and Minority Inclusion in Clinical Research section)
• * History of allergy to Lidocaine for nasal topical anesthesia
• * Allergy to green food dye
• * Asthma patients with an acute asthma exacerbation with symptoms including breathlessness, wheezing, and chest tightness