Cough Reflex Sensitivity and Bronchial Hyper-responsiveness

Inclusion Criteria: * symptomatic reflux (i.e., one symptom at least one day a week, with at least 'moderate' severity) * no evidence of esophagitis * non-smokers Exclusion Criteria: * previous gastrointestinal surgery (excluding minor surgeries, such as cholecystectomy, appendectomy * active peptic ulcer disease * Zollinger Ellison Syndrome * Barrett's esophagus * eosinophilic esophagitis * cardiac disease * diabetes or neurological deficit * use of tricyclics * selective serotonin reuptake inhibitors * narcotics or benzodiazepines * current use of medications that may affect symptoms of perception,lower esophageal sphincter basal pressure, acid clearance time or acid suppression * antibiotics within 60 days * Nursing mothers will be excluded * allergies to citrus * asthma * chronic lung disease * heart attack or stroke within the last three months * hypersensitivity to methacholine products * know aortic aneurysm * uncontrolled hypertension (defined as systolic pressure greater than 200 or diastolic greater than 100) * reduced pulmonary function test (forced expiratory volume in one second (FEV1) or the FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) of less that 70% of predicted value) * None of the controls will have any GERD symptoms or ever used antireflux treatment.