Inclusion Criteria:  Adult patients (age 18 and above) Referred for pH-testing for evaluation of possible extraesophageal-GERD Prior upper endoscopy performed Prior trial of PPI with an inadequate response  Exclusion Criteria:  Patients who do not give consent Patients with abnormalities on their prior endoscopy including a significant hiatal hernia (>3 cm) or significant erosive esophagitis (Los Angeles class B or greater) Patients who did not fail a prior trial of PPI therapy