Gastroesophageal reflux disease (GERD) results from an incompetent lower esophageal sphincter due to inadequate pressure (<6 mmHg), inadequate length (<2 cm), or insufficient intra-abdominal esophagus (<1 cm), leading to increased acid exposure to the esophagus. Associated conditions include hiatal hernia, delayed gastric emptying, and bile reflux. Symptoms can include chest pain, adult-onset asthma, dysphagia, odynophagia, sinusitis, aspiration pneumonia, choking at night, regurgitation, excessive salivation, and chronic hoarseness. Complications include Barrett’s esophagus, esophageal stricture, or erosive esophagitis.