This review focuses on the advances made in the pathophysiology, diagnosis and treatment of gastroesophageal reflux disease. During the last five years, the factors responsible for the disease have been extensively investigated and are now relatively well understood. Little progress, however, has been made with regard to diagnostic techniques, but the roles of endoluminal pH-monitoring and esophageal manometry have greatly increased. Finally, the therapy of the disease has substantially been improved, particularly by the availability of new antisecretory and prokinetic compounds such as omeprazole and cisapride.