Abstract
Gastro-esophageal reflux disease (GERD) is caused by exposure of acid to esophagus, and defined by the presence of esophageal mucosal break and/or symptoms, which lead to impair quality of life. Thus GERD is classified into endoscopy-ositive GERD and endoscopy-negative GERD. Heartburn is major symptom as annoyance of daily life. However, GERD has various symptoms, patients with non -cardiac chest pain, chronic cough, pharyngitis and laryngitis are thought to be associated with occurrence of gastro-esophageal reflux. Recently, GERD is increasing in Japan caused by westernized of dietary habit, increasing of aged population, acid output and H. pylori negative population. Step down therapy; initial PPI treatment is superior strategy for GERD, of its efficacy and cost-effectiveness. Now in Japan, long-term maintenance therapy using PPI is approved, and expected that many patients can be treated with appropriate therapy.
