Hypothesis: The character (nonacid vs. acid) and proximal extension (esophagus and pharynx) of gastroesophageal reflux episodes is different in patients with reflux-induced laryngitis compared to controls. Design: Prospective study using a new tool, (esophageal Multichannel Intraluminal Impedance (MII)) which detects acid and non-acid reflux episodes, simultaneously with traditional 24-hour pH monitoring. Setting: University Referral Center Study population: 30 consecutive patients with suspected reflux-induced laryngitis. Control Group: 10 asymptomatic volunteers without GERD symptoms. Interventions: Simultaneous 24-hour analysis of reflux episodes with a specially designed system which determines impedance and pH measurements in both the esophagus and pharynx of acid and non-acid reflux. Esophageal motility was evaluated with manometry and impedance (esophageal clearance of a swallowed bolus). Main outcome measurement: Acid and nonacid reflux in the esophagus and pharynx Results: Table I depicts the % of time pH was below 4 in the distal esophagus as well as the number and character of reflux episodes in the esophagus and pharynx. Table II shows the manometric and % of swallows that had a normal transit (EBT). Conclusions: Patients with reflux related laryngitis have the same number of episodes of gastroesophageal reflux as controls, but more are non-acid and more reach the pharynx. Impaired esophageal motility may facilitate upward extension of reflux episodes by delaying esophageal clearance.