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Patients with endoscopic evidence of reflux, who had an increase in post-treatment reflux symptoms, were then re-treated with omeprazole 20 mg daily for 8 days and followed up for an additional week. Primary end-points were post-treatment symptom relapse. Seventy-four patients (24 male, 50 female; mean age 10.8 years [range 2.1-16.2]) were recruited. One hundred and one symptomatic relapses occurred in the overall group. This included 30 (43%) in the 1-day group, 17 (25%) in the 4-day group, nine (13%) in the 8-day group and 35 (51%) in the 14-day group. There was no significant difference in post-treatment symptom relapse between the 4-day and 8-day groups (p = 0.46). After re-treatment, there were seven symptomatic relapses, one of which was severe (grade 3 relapse). There was a significant difference in post-treatment symptom relapse between those children treated for 4 days and those treated for 8 days (p = 0.005) and 14 days (p = 0.011). 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