Summary: Esophagoscopy was performed on 116 children with recurrent lower respiratory tract symptoms; esophagitis of various degrees was detected in 45% of the cases. The presence of verified esophagitis correlated with endoscopic findings of bile‐stained gastric contents, suggesting a role of bile reflux in the pathogenesis. Esophageal pH recordings covering an 18‐24‐h period were performed on 22 patients with esophagitis and 19 patients without esophagitis. Gastroesophageal reflux (GER) during the sleeping period was detected in 95% of children with esophagitis, as compared to 42% in children with no esophagitis (p < 0.001). The percentage of time with esophageal pH below 4 of the total registration time was significantly greater (p < 0.05) in children with esophagitis (9.5%) than in those with no esophagitis (4.0%)—the difference being due to a greater share of nocturnal GER of the recording time. These criteria could be applied to a search for clinically significant GER in children with recurrent lower respiratory tract symptoms and to select patients for esophagoscopy.