A new generation of PPI are presently in clinical trials. They are characterized by a quicker and longer effectiveness, very useful for reflux disease treatment. We have to note that the enthusiasm towards the endoscopy treatment for reflux disease is clearly deceasing and two types of procedures have even been recalled from the market. In Helicobacter pylori eradication treatments the tendency tends towards high doses of antibiotics for the second option treatments. The indication for a COX-2 treatment is largely reduced due to the cardiac side effects of certain COX-2. For the patients with high risk of gastro-duodenal toxicity through AINS, the alternative remains the classical non-specific AINS treatment associated with a PPI.