Questionnaire Diagnosis of Airways Reflux

  • Shoaib FaruqiEmail author


Gastro-oesophageal reflux disease may present with extra-oesophageal symptoms. A wide assortment of questionnaires is available to use for the evaluation of different dimensions of the classical symptoms of gastro-oesophageal reflux disease. In contrast, there are very few validated questionnaires available which evaluate extra-oesophageal symptoms. In this review specific questionnaires which evaluate variously termed laryngopharyngeal, supra-oesophageal or airway reflux are described and discussed.


  1. 1.
    El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–80.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Moayyedi P, Axon AT. Review article: gastro-oesophageal reflux disease – the extent of the problem. Aliment Pharmacol Ther. 2005;22(Suppl 1):11–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Holtmann G. Reflux disease: the disorder of the third millennium. Eur J Gastroenterol Hepatol. 2001;13(Suppl 1):S5–11.PubMedGoogle Scholar
  4. 4.
    Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900–20.CrossRefPubMedGoogle Scholar
  5. 5.
    Blondeau K, Dupont LJ, Mertens V, Tack J, Sifrim D. Improved diagnosis of gastro-oesophageal reflux in patients with unexplained chronic cough. Aliment Pharmacol Ther. 2007;25(6):723–32.CrossRefPubMedGoogle Scholar
  6. 6.
    Everett CF, Morice AH. Clinical history in gastroesophageal cough. Respir Med. 2007;101(2):345–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Belafsky PC, Postma GN, Koufman JA. The validity and reliability of the reflux finding score (RFS). Laryngoscope. 2001;111(8):1313–7.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Faruqi S, Molyneux ID, Fathi H, Wright C, Thompson R, Morice AH. Chronic cough and esomeprazole: a double-blind placebo-controlled parallel study. Respirology. 2011;16(7):1150–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014;5(3):105–12.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Madan K, Ahuja V, Gupta SD, Bal C, Kapoor A, Sharma MP. Impact of 24-h esophageal pH monitoring on the diagnosis of gastroesophageal reflux disease: defining the gold standard. Gastroenterol Hepatol. 2005;20(1):30–7.CrossRefGoogle Scholar
  11. 11.
    Gawron AJ, Pandolfino JE. Ambulatory reflux monitoring in GERD – which test should be performed and should therapy be stopped? Curr Gastroenterol Rep. 2013;15(4):316.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Bolier EA, Kessing BF, Smout AJ, Bredenoord AJ. Systematic review: questionnaires for assessment of gastroesophageal reflux disease. Dis Esophagus. 2015;28(2):105–20.CrossRefPubMedGoogle Scholar
  13. 13.
    Morice AH, Faruqi S, Wright CE, Thompson R, Bland JM. Cough hypersensitivity syndrome: a distinct clinical entity. Lung. 2011;189(1):73–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002;16(2):274–7.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Dauer E, Thompson D, Zinsmeister AR, Dierkhising R, Harris A, Zais T, Alexander J, Murray JA, Wise JL, Lim K, Locke GR 3rd, Romero Y. Supraesophageal reflux: validation of a symptom questionnaire. Otolaryngol Head Neck Surg. 2006;134(1):73–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Andersson O, Rydén A, Ruth M, Möller RY, Finizia C. Development and validation of a laryngopharyngeal reflux questionnaire, the Pharyngeal Reflux Symptom Questionnaire. Scand J Gastroenterol. 2010;45(2):147–59.CrossRefPubMedGoogle Scholar
  17. 17.
    Drinnan M, Powell J, Nikkar-Esfahani A, Heading RC, Doyle J, Griffin SM, Leslie P, Bradley PT, James P, Wilson JA. Gastroesophageal and extraesophageal reflux symptoms: similarities and differences. Laryngoscope. 2015;125(2):424–30.CrossRefPubMedGoogle Scholar
  18. 18.
    Rothman M, Farup C, Stewart W, Helbers L, Zeldis J. Symptoms associated with gastroesophageal reflux disease: development of a questionnaire for use in clinical trials. Dig Dis Sci. 2001;46(7):1540–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Lechien JR, Huet K, Finck C, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S. Validity and reliability of a French version of reflux symptom index. J Voice. 2017;31(4):512.e1–7.CrossRefGoogle Scholar
  20. 20.
    Schindler A, Mozzanica F, Ginocchio D, Peri A, Bottero A, Ottaviani F. Reliability and clinical validity of the Italian reflux symptom index. J Voice. 2010;24(3):354–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Farahat M, Malki KH, Mesallam TA. Development of the Arabic version of reflux symptom index. J Voice. 2012;26(6):814.e15–9.CrossRefGoogle Scholar
  22. 22.
    Lapeña JFF Jr, Ambrocio GMC, Carrillo RJD. Validity and reliability of the Filipino reflux symptom index. J Voice. 2017;31(3):387.e11–6.CrossRefGoogle Scholar
  23. 23.
    Li J, Zhang L, Zhang C, Cheng JY, Li J, Jeff Cheng CF. Linguistic adaptation, reliability, validation, and responsivity of the Chinese version of reflux symptom index. J Voice. 2016;30(1):104–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Brauer DL, Tse KY, Lin JC, Schatz MX, Simon RA. The utility of the reflux symptom index for diagnosis of laryngopharyngeal reflux in an allergy patient population. J Allergy Clin Immunol Pract. 2018;6:132–8.e1.CrossRefPubMedGoogle Scholar
  25. 25.
    Lin RJ, Sridharan S, Smith LJ, Young VN, Rosen CA. Weaning of proton pump inhibitors in patients with suspected laryngopharyngeal reflux disease. Laryngoscope. 2018;128:133–7. Scholar
  26. 26.
    Zhang C, Hu ZW, Yan C, Wu Q, Wu JM, Du X, Liu DG, Luo T, Li F, Wang ZG. Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale. World J Gastroenterol. 2017;23(19):3546–55.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Catania RA, Kavic SM, Roth JS, Lee TH, Meyer T, Fantry GT, Castellanos PF, Park A. Laparoscopic Nissen fundoplication effectively relieves symptoms in patients with laryngopharyngeal reflux. J Gastrointest Surg. 2007;11(12):1579–87.CrossRefPubMedGoogle Scholar
  28. 28.
    Kim SJ, Kim HY, Jeong JI, Hong SD, Chung SK, Dhong HJ. Changes in the reflux symptom index after multilevel surgery for obstructive sleep apnea. Clin Exp Otorhinolaryngol. 2017;10(3):259–64.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Huang Y, Yu L, Xu XH, Chen Q, Lyu HJ, Jin XY, Qiu ZM. Validation of the Chinese version of Hull airway reflux questionnaire and its application in the evaluation of chronic cough. Zhonghua Jie He He Hu Xi ZaZhi. 2016;39(5):355–61.Google Scholar
  30. 30.
    Johansson EL, Ternesten-Hasséus E. Reliability and validity of the Swedish version of the hull airway reflux questionnaire (HARQ-S). Lung. 2016;194(6):997–1005.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Fahim A, Dettmar PW, Morice AH, Hart SP. Gastroesophageal reflux and idiopathic pulmonary fibrosis: a prospective study. Medicina (Kaunas). 2011;47(4):200–5.Google Scholar
  32. 32.
    Zeybel GL, Pearson JP, Krishnan A, Bourke SJ, Doe S, Anderson A, Faruqi S, Morice AH, Jones R, McDonnell M, Zeybel M, Dettmar PW, Brodlie M, Ward C. Ivacaftor and symptoms of extra-oesophageal reflux in patients with cystic fibrosis and G551D mutation. J Cyst Fibros. 2017;16(1):124–31.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Mandal P, Morice AH, Chalmers JD, Hill AT. Symptoms of airway reflux predict exacerbations and quality of life in bronchiectasis. Respir Med. 2013;107(7):1008–13.CrossRefPubMedGoogle Scholar
  34. 34.
    Faruqi S, Shiferaw D, Morice AH. Effect of ivacaftor on objective and subjective measures of cough in patients with cystic fibrosis. Open Respir Med J. 2016;10:105–8.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Smith JE, Morjaria JB, Morice AH. Dietary intervention in the treatment of patients with cough and symptoms suggestive of airways reflux as determined by Hull airways reflux questionnaire. Cough. 2013;9(1):27.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Faruqi S, Sedman P, Jackson W, Molyneux I, Morice AH. Fundoplication in chronic intractable cough. Cough. 2012;8(1):3.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Respiratory MedicineHull York Medical School and the Hull and East Yorkshire Hospitals NHS TrustHullUK

Personalised recommendations