Which of the following may be considered a less common symptom of GERD?

Hoarseness can indeed be considered a less common symptom of gastroesophageal reflux disease (GERD). While GERD is traditionally associated with symptoms such as heartburn and regurgitation, it can also lead to extraesophageal symptoms due to acid reflux impacting areas outside the esophagus, including the throat and voice box (larynx). This can result in laryngitis, which presents as hoarseness.

In contrast, the other symptoms listed, such as vomiting and fatigue, are more commonly recognized in association with GERD. Vomiting can occur due to severe reflux, and fatigue may arise from disrupted sleep caused by nighttime reflux symptoms. Constipation, while not a primary symptom of GERD, can be seen as a co-occurring condition but is still not primarily associated with GERD as its immediate causes are usually related to digestive issues other than acid reflux.

Thus, hoarseness stands out as a less frequently discussed symptom in the typical presentations of GERD.