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In the article by Mr Issing and Mr Karkos (October 2003 JRSM1) I was surprised that my presenting symptom was not mentioned. Perhaps I am unique. I first experienced gastrooesophageal reflux disease (GORD) when I was in a hotel room in a large US city. I was woken at 2 am by laryngeal spasm and stridor so severe that I was convinced I was going to asphyxiate and die. It passed off in about 25–30 s. It happened every few months after that: my terror decreasing only slightly with each episode (my wife was the recipient of ‘surrogate terror’, the first time she saw and heard me gasping and making that horrific inspiratory screech). It was so bad that I have since wondered whether laryngeal spasm due to reflux might be a cause of otherwise unexplained and unwitnessed solitary deaths in bed, particularly in the elderly and those weakened by disease. After a few of these episodes I eventually did have an endoscopy and now sleep undisturbed courtesy of my proton pump inhibitors.