There is more to gastroesophageal reflux disease (GERD) than heartburn, acid, and erosive esophagitis. The severity of the patient's symptoms does not correlate with the severity of erosive esophagitis, and indeed some patients with severe symptoms have a normal endoscopy. When comparing the efficacy of one therapeutic agent with that of another, similar outcomes need to be considered and supraesophageal as well as infraesophageal symptoms need to be taken into account. Only when this is achieved can one better appreciate complete remission, both in terms of dyspeptic symptoms and alteration in endoscopic abnormalities. The use of outcomes such as intragastric pH and endoscopic scoring of erosive esophagitis is not enough. The recently used ReQuest® scale meets all the criteria for an ideal outcome measure for clinical trials in GERD. The scale has been used to date in several clinical trails comparing 2 proton pump inhibitors. In the future, research using ReQuest® which incorporates the Los Angeles classification of erosive esophagitis may better assess the optimal length of GERD therapy. This concept of complete remission might lead to the possible identification of those individuals who would do better with varying modalities of long-term management (such as on-demand or continuous maintenance therapy), and possibly identifying those individuals who could be provided with a lower dose of proton pump inhibitor. This would potentially have pharmacoeconomic implications for disease management.