Gastroesophageal reflux disease (GERD) is a disorder of gastrointestinal motility associated with reflux of stomach content in to the esophagus and oral cavity. Approximately one quarter of people living in western country have experienced GERD, and the prevalence appears to be on the rise. Drinking certain beverages such as alcohol or coffee, eating certain foods such as fatty and fried food, eating large meals late at night, smoking, medications such as aspirin are the most common etiological factors of GERD. The primary treatment goals in patient with GERD disease are relief of symptoms, prevention of symptom relapse, healing of erosive esophagitis and prevention of complications of esophagitis. In patients with reflux esophagitis, treatment is directed at acid suppression through the use of life style modification and pharmacological agents like H2receptor antagonist and proton pump inhibitors. The preferred empiric approach is step up therapy (treat initially with an H2 receptor antagonist for 8 weeks; if symptoms do not improve change to a PPI) or stepdown therapy (treat initially with a PPI then titrate to the lowest effective medication type and dosage).