Background/Aims: Reflux esophagitis is one of common complications appeared after gastric surgeries. Bile reflux is considered as an important mechanism. Recently, reflux of pancreatic juice is also suggested as another important mechanism. Methods: In prospective randomised controlled studies on 80 patients with reflux symptoms after gastrectomy, the effects of treatment with camostat mesilate (Foipan ), a trypsin inhibitor, were compared with those of treatment with other commonly prescribed drugs. Forty seven patients received camostat mesilate 300 mg/day for 8 weeks, and 33 patients were enrolled as other drug controls. Results: The rate of subjective symptom (heartburn) relief in the camostat mesilate treatment group was 87% after 8 weeks of treatment. Symptorns of regurgitation were relieved in 95% of patients, epigastric soreness in 85%, and dysphagia in 72%. In the control group, heartburn was relieved in 75% of patients after 8 weeks of treatment, regurgitation in 82%, epigastric soreness 75% dysphagia ln 80%. The symptoms of heartburn, regurgiation and epigastric soreness in the camostat treated group were significantly improved in comparison with the control group (p<0.05). Moreover, the therapeutic effect was observed in early stage of treatment. In addition, there was no relationship between the severity of symptoms and the degree of endoscopic abnormality. There was no specific side effect in the camostat mesilate treatment group. Conclusions: These results suggest that camostat mesilate (Foipan) is effective in alleviating the symptoms of reflux esophagitis without significant side effect. (Korean J Gastroenterol 1998;31:275-280)