A BR THOMSON, MD, PHO, FRCPC, FACP, FACG, FRS ABR THOMSON. Medical treatment of gastroesophageal reflux disease:Options and priorities. Can J Gastroenterol 1993;7(4):364-379. Gastroesophageal reflux disease (GERO) represents a spectrum of symptoms and of reflux damage to the esophagus. This reflux damage is due to prolonged acid exposure of the esophagus arising from an imbalance between protective motility factors and aggressive acid secretory factors. Initially, patients may be managed by modifying food intake and by supportive antigravity measures. However, many individuals will require drug therapy. Symptomatic relief can be achieved with prokinetic agents, antacids, sucralfate suspension, Hz-receptor antagonists and H\K+ -ATPase pump blockers. There are limitations in the study design of experiments which have compared one agent with another. Accepting these design restrictions, it would appear that pump blockers lead to higher rates of endoscopic healing than the use of standard doses of Hz-receptor antagonists. However, higher doses of Hz-receptor antagonists will likely give higher races of symptomatic relief and endoscopic healing of GERO. Recurrence of symptoms and esophagitis occur in a high proportion of patients with GERO, and some patients may need to be considered for maintenance therapy.