Birmingham, AL | ENT Specialists
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Acid Reflux Quiz
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Take the Acid Reflux Quiz

Do I have acid reflux?

Discover if you may be experiencing acid reflux by taking our quick quiz below. Rest assured that your quiz responses will be kept confidential. If the results suggest a potential presence of acid reflux, we encourage you to schedule an appointment with our dedicated specialists for a thorough evaluation and personalized treatment options.

"*" indicates required fields

Name*

Within the past month, how did the following affect you?

0 = No problem       5= Severe
Hoarseness or a problem with your voice*
Excess throat mucus or postnasal drip*
Coughing after you ate or after lying down*
Breathing difficulties or choking episodes*
Clearing your throat*
Troublesome or annoying cough*
Sensation of something sticking in your throat or a lump in your throat*
Heartburn, chest pain, indigestion, or stomach acid coming up*

GERD/LPR Checklist for Diet/Lifestyle Management

Answer YES or NO to each of the 10 questions. Answer questions based on the last month.
I eat spicy, acidic, tomato-based, fatty foods, chocolate, peppermint, citrus fruits, fruit juices.*
I am overweight and have extra weight around my waist.*
I only eat 2-3 large meals a day.*
I exercise right after I eat.*
I wear tight, restrictive clothes around my waist.*
I drink coffee, tea, alcohol, and colas.*
I smoke.*
I lie down right after I eat.*
I lie flat on my bed and do not elevate the head of my bed EXCEPT for pillows.*
I do NOT take the reflux medication as prescribed by my physician.*
*Score = 10 minus # of YES responses
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To schedule an appointment with one of our Birmingham ENT specialists, call us at (205) 988-6858, or send us an appointment request.

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