The classic symptoms of episodic heartburn and regurgitation associated with over-indulgence are well known to a large segment of the population, and are the hallmark of gastro-oesophageal re¯ux disease (GERD).1 Approximately 30% of adults contacted in a large US survey reported having suffered heartburn, acid indigestion or sour stomach, common terms used with over-the-counter products, within the past month; more than 20% of these individuals reported experiencing heartburn at least once per day.2 Nearly all of the sufferers (93%) in the survey treated their symptoms with a non-prescription product.2 Most individuals with mild symptoms of gastro-oesophageal re¯ux are not seen by physicians, consistent with the iceberg analogy proposed by Castell, which suggests that the vast majority of individuals with GERD, having only mild and/or sporadic symptoms, primarily heartburn, are represented by the largest submerged portion of the iceberg.3 These particular individuals function well without medical intervention and are unlikely to discuss their symptoms with a physician. It is this population who consumes the largest portion of antacids. In SUMMARYBackground: Approximately 30% of adults in the USA suffer from heartburn or related symptoms monthly; more than 20% of these sufferers experience heartburn at least once per day. Although many rely on selfmedication with antacids for the relief of their symptoms, treatments that decrease gastric volume as well as increase the pH of re¯uxed material should be more effective in relieving heartburn. Aim: To compare the safety and ef®cacy of low-dose regimens of ranitidine for the relief of heartburn. Methods: Adults with at least a 3-month history of heartburn were eligible for this randomized, doubleblind, parallel group, multicentre dose-ranging study. Following a 1-week open-label run-in phase to document baseline heartburn frequency, subjects were randomized to receive treatment with one tablet of either ranitidine 75 mg (n 491), ranitidine 25 mg