Mechanisms Preventing Pharyngeal Reflux

Inclusion Criteria: * Age 18 to 85 * GERD patients with complaints of regurgitation and supra-esophageal symptoms will be included and recruited from our GI \& Otolaryngology clinics * GERD patients without complaint of supra-esophageal symptoms and regurgitation will be included and recruited from our GI \& Otolaryngology clinics * Asthma patients with and without supra-esophageal symptoms will be included and recruited from clinics affiliated with Medical College of Wisconsin. Asthma patients with the following classifications of asthma severity will be included: intermittent, mild persistent, moderate persistent, and severe persistent (as long as no acute asthma exacerbation at the time of the study) * Patient definition will be based on position statement and technical reviews of the American Gastroenterological Association and Montreal definition and classification of gastroesophageal and reflux disease (Am J Gastroenterol. 2006;101:1900-1920). * SERD is defined as patients on long term acid suppressive therapy complaining of persistent regurgitation along with supra-esophageal manifestations such as burning throat, asthma, chronic cough, or hoarseness. Patients will be screened by Reflux Symptom Index \> 13. * Barrett's esophagus patients will be recruited based on histological diagnosis from previous endoscopic biopsy that will be found using the clinical database warehouse. Exclusion Criteria: * Age \<18 or \>85 * Active alcohol or drug abuse * History of ear, nose, throat and pulmonary diseases suspected of being GERD induced * History of head and neck malignancy and chemo-radiation therapy to the head and neck * Unable to give consent * Pregnant women (see justification in the Women and Minority Inclusion in Clinical Research section) * History of allergy to Lidocaine for nasal topical anesthesia * Allergy to green food dye * Asthma patients with an acute asthma exacerbation with symptoms including breathlessness, wheezing, and chest tightness