Radiology, endoscopy and function tests were performed in 30 patients with primary reflux disease. Follow-up examinations were performed 3.2 +/- 1.5 years later. Esophagitis was more frequent in men. Severity of esophagitis correlated neither with the duration of symptoms before diagnosis nor with the results of function tests. Neither esophagitis nor function tests allowed a prediction on the long-term severity of symptoms. Episodic symptoms were more frequent in patients with esophagitis and constant symptoms more frequent in those without esophagitis. The indication for conservative and surgical treatment mainly depended on chance. Good therapeutic results were obtained in only 11 of 17 patients undergoing conservative treatment and in 9 of 13 patients undergoing surgical treatment. 6 patients of the surgical group had postfundoplication symptoms. Thus, the results of conservative and surgical treatment were quantitatively similar and rather disappointing.