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Gastro-oesophageal reflux disease (GORD) and its complications account for a significant part of the workload for gastroenterologists, surgeons and primary care physicians. However, the knowledge about reflux symptoms, oesophagitis and Barrett’s oesophagus in the general population is limited. In this issue Zagari et al present a population-based study including endoscopy, assessment of reflux symptoms, potential risk factors and various demographic factors in 1033 subjects living in two villages in northern Italy. The prevalence of reflux symptoms was 44.3%, and 23.7% of the population experienced frequent symptoms, that is at least 2 days per week. The prevalence rates of oesophagitis and Barrett’s oesophagus in the population were 11.8% and 1.3%, respectively. Reflux symptoms were associated with the presence of oesophagitis (see fig), but interestingly enough no reflux symptoms were reported by 32.8% of individuals with oesophagitis and 46.2% of those with Barrett’s oesophagus. Hiatus hernia, but surprisingly not body mass index, was associated with reflux symptoms, oesophagitis and Barrett’s oesophagus. Studies like this one are needed to better understand the generation of reflux symptoms and risk factors for the development of complications to GORD. See p 1354