OBJECTIVES: To evaluate the timing and degree of symptom relief with rabeprazole in a real life setting of patients with gastro-oesophageal reflux disease (GERD). METHODS: A prospective, multi-centre, observational study was conducted in which Canadian general practitioners (n=115) prescribed rabeprazole to adults with GERD. Subjects had to be newly diagnosed or demonstrate insufficient control on their current PPI, H2-antagonist and/or antacid and not have used rabeprazole previously. At the baseline office visit (Day 0), physicians collected demographic and clinical history data. Subjects were prescribed rabeprazole (2 x 10 mg daily) and sent home with a seven-day diary to record symptom severity and symptom control. Subjects also completed a Global Symptom Rating on Day 7 with improvement defined as equal to or greater than 1 point change in severity rating. RESULTS: Of the 312 subjects who reported taking rabeprazole on Day 0, more than half were over 50 years of age and 56% female. The number of subjects reporting baseline Daytime Heartburn (D-HB), baseline Night-time Heartburn (N-HB), and Regurgitation (R) were 245, 230 and 194 respectively. 63% of D-HB, 73% of N-HB and 72% of R reported improvement within the first 2 days of therapy. Of the subjects experiencing improvement during the first two days of therapy, 83% of D-HB, 83% of N-HB and 82% of R maintained or further improved symptoms to the end of the study. Overall, the majority of patients (76%) indicated marked (56%) or moderate (20%) improvement for the onetime Global Symptom Rating score on Day 7. CONCLUSIONS: Rabeprazole demonstrated a high level of effectiveness within the first two days of therapy, which was maintained in subjects with a prolonged history of GERD, including those with prior PPI treatment. The results of this real world study provided valuable information on the true efficacy of rabeprazole.