Prevalence of symptoms suggestive of extra-oesophageal reflux in a general practice population in the UK

Unlike gastro-oesophageal reflux, extra-oesophageal reflux (EOR) is not necessarily associated with heartburn. The potential prevalence of EOR in general practice in the UK using the Reflux Symptom Index (RSI) questionnaire was determined. A total of 1152 patients attending a GP surgery for routine conditions completed the RSI questionnaire: 26.5% had an RSI score 10, regarded as a clinically significant score for EOR; 29% of patients with a significant RSI score rated the impact of heartburn in the previous month as zero. Significant numbers of patients presenting to GPs have high RSI scores suggesting significant reflux. Many patients likely to have EOR do not experience classical heartburn. This might explain why some GPs may not attribute common symptoms affecting the throat to gastric reflux.