Assessment of treatment efficacy was symptom-based.20 and 21 Improvements in common GERD symptoms were measured according to a modified Reflux Disease Questionnaire,22 which is a validated, self-administered scale that is widely used for the assessment of anti-reflux treatment effects.23 The frequencies of eight main symptoms of GERD, namely heartburn, food regurgitation, flatulence, belching, dysphagia, nausea, vomiting and acid regurgitation, were assessed at weeks 2 and 4 of the trial and were compared between the different treatment arms.