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Gastro-esophageal reflux disease is a very common disease. Natural history provides an alternative to wellness and reactivating the disease. The purpose of this article is to review the condition of gastroesophageal reflux disease. The article discusses the diagnostic methods, the clinical presentations and the higher incidence of atypical forms and high reflux symptoms. Many patients are not responding to therapy and those who respond to drugs become dependent on the cure. Medical therapy has some adverse events such as anemia, osteoporosis, and infections. Physiotherapy can be an alternative treatment that offers a temporal benefit.Surgical therapy is performed with laparoscopy, which is less invasive than open procedure and reduces the time of stay. Endoscopic surgery is devoid of postoperative complications and is easily executable. It can be carried out with one day residency. The article outlines the various endoscopic techniques of recent years and reports scientific studies. From these it appears that the efficacy of endoscopic therapies for the treatment of GERD has not been documented with certainty. So, despite the dream of resolving gastroesophageal reflux with mini-invasive or, even better, endoscopic surgical procedures, the experience of real life teaches us that the medical therapy is effective in most cases and risk free, if the patient is followed closely.

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