Of the more than 60 million adult Americans who have heartburn at least once a month, 60% choose over-the-counter medication rather than consulting their physician. Those individuals who do seek medical advice for reflux symptoms will probably receive a prescription for an H2-receptor antagonist, although in many instances simple life-style changes and occasional use of antacids may provide effective therapy. Patients who have severe esophagitis or reflux symptoms unresponsive to H2-receptor antagonists may be treated with a more potent antisecretory agent (proton pump inhibitor). The author discusses the role of antacids and acid inhibition in the treatment of gastroesophageal reflux disease. The results of the clinical trials with the H2-receptor antagonists, cimetidine, ranitidine, famotidine, and nizatidine, and the proton pump inhibitor omeprazole, are compared and contrasted.