Gastroesophageal reflux disease (GERD) is due to pathologic reflux that causes symptoms and complications, including erosive esophagitis. Common symptoms are heartburn, early satiety, bloating, and belching. Diagnosis is made clinically and requires endoscopy in adults over 55 who are unresponsive to empiric therapy with acid blockade or those with alarm symptoms. Uncomplicated GERD can be managed with lifestyle changes and over-the-counter medications. Complications include erosive esophagitis, stricture, and Barrett esophagus, which can increase the risk of esophageal cancer. Management includes lifestyle and dietary modification, acid-reducing medications, and in some cases, surgery.