**5. Symptoms**

GERD patients usually present with wide symptoms of esophagitis, including heartburn and burning sensation, chest pain, and acid regurgitation, which are important diagnostic factors. Patients mainly report a burning feeling in the retrosternal area, spreading into the chest and neck. It occurs mostly post-prandially. Chronic cough, dysphagia, globus sensation, and irritable throat discomfort can present as atypical manifestations in patients with GERD as extraesophageal symptoms. Some patients with GERD are asymptomatic. Some clinical studies show that reflux is the only cause of chronic cough in 10% of patients [19].

The most prevalent symptoms associated with LPR are related to the upper respiratory tract: globus sensation, hoarseness, throat clearing, excess throat mucus or postnasal drip. These symptoms, which are commonly observed in primary care medicine, are nonspecific and often intermittent. Throat pain, sore throat, expectoration, dysphagia, and halitosis can also be presented [1]. Patients with LPR are more likely to suffer from insomnia [20].

GERD symptoms typically occur in supine position, but LPR patients mainly have upright and daytime reflux events [21]. The main differences in clinical presentation are shown in **Table 2**.
