Esophageal diseases are diagnosed by gastroenterological processing indicated due to typical gastrointestinal symptoms, but typical gastrointestinal symptoms are not the only possible manifestation of esophageal disease. There are also external symptoms such as chronic cough, laryngitis, pharyngitis, oropharyngeal dysphagia, odynophagia, laryngopharyngeal reflux, dysphonia, sinusitis, ear pain, and changes in laryngopharyngeal mucosa (erythema, edema, ventricular obliteration, cricoid hyperplasia and pseudosulcus). Extraesophageal symptoms are common in esophagitis and GERD, and studies show increasing prevalence of LPR in patients with GERD, as well as an association of reflux disease with cough and dysphonia symptoms. The aim of the chapter is to describe these extraesophageal symptoms of esophageal disease and how to recognize and treat them, in order to facilitate gastroenterologists’ diagnostic processing of patients with these symptoms, improve their treatment and assessment of the therapy effectiveness, prevent the development of stronger symptoms, and encourage multidisciplinary cooperation and exchange of knowledge, scientific and clinical work.

Gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) have different pathophysiological mechanisms of occurrence and are characterized by different clinical pictures and symptomatology. In clinical practice, it often happens that LPR remains unrecognized or is defined as atypical gastroesophageal reflux, thus, it is necessary to distinguish between these two clinical entities. Laryngopharyngeal reflux refers to the return of gastric contents from the stomach through the esophagus to the larynx, pharynx, paranasal cavities, middle ear, and lower respiratory tract, and it is part of the wider extraesophageal reflux syndrome (EER). Extraesophageal symptoms are common in GERD, and studies show an increasing prevalence of LPR in patients with GERD, as well as an association of reflux disease with cough and dysphonia symptoms. The aim of the chapter is to describe differences between GER and LPR in order to facilitate the recognition and differentiation of manifest and latent symptoms, diagnosis, and choice of therapeutic approach.