The most common atypical presentation of GERD may include ear, nose, and throat (ENT) symptoms, pulmonary (chronic cough or asthma), or cardiac symptoms (noncardiac chest pain). Therefore, GERD should be strongly considered in the differential diagnosis of patients with atypical symptoms when alternative diagnoses have been ruled out by another specialist (ear, nose and throat surgeon, physician) cardiologist, pulmonologist, allergist).

Diagnosis of GERD is difficult and is usually made by a combination of clinical symptoms, response to acid suppression, as well as objective testing with upper gastrointestinal endoscopy and esophageal pH monitoring.