- Gastroesophageal reflux disease (GERD) is a common, typically chronic recurring disorder. The majority of patients with heartburn and regurgitation have intermittent symptoms for which they do not consult their physicians. The main long-term risk of esophagitis is adenocarcinoma arising from Barrett's metaplasia. There are two principle therapeutic strategies in the treatment of GERD. The use of prokinetic drugs aims at treating the primary motility disorder leading to reflux, whereas acid-suppressive therapy targets at the reduction of gastric acid production to prevent symptoms and complication of GERD. The cornerstone in the treatment of GERD are proton pump inhibitors (PPI). Patients with mild symptoms and rarely relapsing disease may be best treated intermittently. Longterm maintenance acid-suppressive therapy with PPIs is necessary in GERD patients with immediate and severe relapse. At present, eradication of Helicobacter pylori in GERD patients is not recommended. Antireflux surgery is an effective treatment to control gastroesophageal reflux. However, surgery is associated with a low, but still substantial morbidity, a low mortality of up to 0.5% and is only indicated in patients with pharmacological refractory reflux disease.