Inclusion Criteria:  Male or female subjects (females of childbearing potential should be on highly effective contraceptive methods) Aged 18-80 years old Mentally capable to provide informed consent Fluent in English Have symptoms of GERD (heartburn, regurgitation, and non-cardiac chest pain) Have failed an appropriate compliant trial of PPI therapy with a GERDQ score ≥6. Able to undergo endoscopy, ambulatory reflux monitoring, and manometry Be interested in behavioral interventions for ongoing symptoms.  Exclusion Criteria:  Participation in a concurrent clinical trial or completed another trial within past 8 weeks. Active severe erosive esophagitis (Los Angeles Grade C or D), Long segment Barrett's esophagus (Zap score of 4) Prior gastrointestinal surgery of the esophagus and/or stomach Current signs or symptoms of heart disease. All patients with non-cardiac chest pain are required to have a cardiologist evaluation as standard of care work up in the evaluation of non-cardiac chest pain. Unstable medical illness with ongoing diagnostic work-up and treatment. Patients with well-controlled hypertension, diabetes and a remote history of ischemic heart disease that is deemed stable, as judged by the investigator can be included. History of drug addiction, drug abuse or alcoholism. Current neurologic or cognitive impairment, which would preclude ability to obtain informed consent. Pregnant patients. Special vulnerable populations including children, prisoners, institutionalized individuals. Bleeding disorder or requirement of NSAID/aspirin during monitoring period. Drugs that affect gastrointestinal symptoms (H2 blockers, antacids, metoclopramide, domperidone, erythromycin, anticholinergics [bentyl, levsin, belladonna etc.]). Antidepressants can be continued at stable dose. Patients found to have achalasia, a spastic disorder, hypercontractile disorder or functional obstruction at the esophagogastric junction will be excluded