Objective　Since　the　publication　of　the　Asia-Pacific　consensus　on　gastro-oesophageal　reflux　disease　in　2008,　there　has　been　further　scientific　advancement　in　this　field.　This　updated　consensus　focuses　on　proton　pump　inhibitor-refractory　reflux　disease　and　Barrett＇s　oesophagus.　Methods　A　steering　committee　identified　three　areas　to　address:　(1)　burden　of　disease　and　diagnosis　of　reflux　disease;　(2)　proton　pump　inhibitor-refractory　reflux　disease;　(3)　Barrett＇s　oesophagus.　Three　working　groups　formulated　draft　statements　with　supporting　evidence.　Discussions　were　done　via　email　before　a　final　face-to-face　discussion.　We　used　a　Delphi　consensus　process,　with　a　70%　agreement　threshold,　using　Grading　of　Recommendations　Assessment,　Development　and　Evaluation　(GRADE)　criteria　to　categorise　the　quality　of　evidence　and　strength　of　recommendations.　Results　A　total　of　32　statements　were　proposed　and　31　were　accepted　by　consensus.　A　rise　in　the　prevalence　rates　of　gastro-oesophageal　reflux　disease　in　Asia　was　noted,　with　the　majority　being　non-erosive　reflux　disease.　Overweight　and　obesity　contributed　to　the　rise.　Proton　pump　inhibitor-refractory　reflux　disease　was　recognised　to　be　common.　A　distinction　was　made　between　refractory　symptoms　and　refractory　reflux　disease,　with　clarification　of　the　roles　of　endoscopy　and　functional　testing　summarised　in　two　algorithms.　The　definition　of　Barrett＇s　oesophagus　was　revised　such　that　a　minimum　length　of　1　cm　was　required　and　the　presence　of　intestinal　metaplasia　no　longer　necessary.　We　recommended　the　use　of　standardised　endoscopic　reporting　and　advocated　endoscopic　therapy　for　confirmed　dysplasia　and　early　cancer.　Conclusions　These　guidelines　standardise　the　management　of　patients　with　refractory　gastro-oesophageal　reflux　disease　and　Barrett＇s　oesophagus　in　the　Asia-Pacific　region.