Reflux Symptoms Index
| Reflux Symptom Index | 0=no problem 5=severe problem |
| 1. Hoarseness or a problem with your voice | 0 1 2 3 4 5 |
| 2. Clearing your throat | 0 1 2 3 4 5 |
| 2. Excess throat mucous or postnasal drip | 0 1 2 3 4 5 |
| 4. Difficulty swallowing food, liquids or pills | 0 1 2 3 4 5 |
| 5. Coughing after you ate or lying down | 0 1 2 3 4 5 |
| 6. Breathing difficulties or choking episodes | 0 1 2 3 4 5 |
| 7. Troublesome or annoying cough | 0 1 2 3 4 5 |
| 8. Sensations of something sticking in your throat or a lump in your throat | 0 1 2 3 4 5 |
| 9. Heartburn, chest pain, indigestion or stomach acid coming up | 0 1 2 3 4 5 |
| Total |