CLINICAL RELEVANCE OF THIS STUDY GERD is a well known, widely prevalent, clinical entity. The symptoms of GERD if not relieved can affect the daily functioning/productivity of individuals. This can be especially frustrating for some patients, who may spend hundreds of dollars every year on prescription medications, and are still not able to obtain relief of their symptoms. In the United States alone, it is estimated that PPI costs alone make up over $10billion/year (5). However, despite these staggering costs, it is clear that even PPI therapy is not the definitive answer for all patients. Indeed, it has been reported that 37% of patients receiving PPIs also note concomitant antacid use. This finding underscores the fact that even with PPI therapy, a large percentage of patients do not achieve full symptom relief. When left untreated--or when treated inadequately--severe GERD can progress to esophagitis, esophageal ulcers, esophageal strictures, laryngeal disease, chronic cough, Barrett's esophagus, and esophageal adenocarcinoma. Clearly, such patients with refractory symptoms are the ones in the direst need for additional modalities of therapy. Yoga and acupuncture may be a promising option for these patients, as they represent cost-effective, yet underused, options which may be usefully employed to control the symptoms of GERD.