Gastroesophageal reflux disease (GERD) is a common clinical problem, affecting millions of people worldwide. Patients are recognized by both classic and atypical symptoms. Acid suppressive therapy provides symptomatic relief and prevents complications in many individuals with GERD. Advances in diagnostic and therapeutic modalities have improved our ability to identify and manage disease complications. Here, we discuss the pathophysiology and effects of GERD, and provide information on the clinical approach to this common disorder. Introduction Symptoms and complications that result from the reflux of stomach contents Gastroesophageal reflux disease (GERD) is a very common digestive disorder worldwide with an estimated prevalence of 18.1–27.8% in North America.Approximately half of all adults will report reflux symptoms at some time. According to the Montreal definition, GERD is a condition of troublesome synts into the esophagus. Diagnosis of GERD is typically based on classic symptoms and response to acid suppression after an empiric trial. GERD is an important health concern as it is associated with decreased quality of life and significant morbidity. Successful treatment of GERD symptoms has been associated with significant improvement in quality of life, including decreased physical pain, increased vitality, physical and social function, and emotional well-being. While GERD medications are not particularly expensive, the cost of treating GERD patients has been deemed 2-fold more costly than comparable individuals without GERD.This cost difference is likely due to higher morbidity in GERD patients and the higher cost of managing complications of inappropriately treated GERD.