Sometimes reflux has symptoms that no one is aware of because they are subtle. It's also possible that if he's always had symptoms he doesn't even know to tell you about them. One day when my daughter was 5 or 6 she said to me "Mommy, sometimes my mouth gets really hot." When asked further she said it happened a few times a week.   At 9 she got a chronic cough that we couldn't get rid of with allergy or asthma meds. Once on reflux meds though the cough went away. When we stop them it's back.   So, while no, I wouldn't want to put him through a needless test, it is possible that he does have reflux that has gone under radar until now. I've also heard it possible to get similar wear due to sodas and juice. Have the docs talked about this as a possibility?   Finally, whenever you question the suggestions of a doc, it's always okay to seek a second opinion or to even ask the doc what the other alternatives are.   Good Luck - Stephanie