Reflux esophagitis is a common disease with a variety of manifestations. Reflux is a series of discomforts caused by the reversal of stomach contents into the esophagus, the extent and frequency of which varies from person to person. Typical manifestations of reflux esophagitis are heartburn and vomiting. Patients often say that my chest feels like burning after drinking white wine; others are unable to lie down and vomit at night when they sleep. In addition, the manifestations of reflux esophagitis are extremely diverse, and many patients are seen in cardiology, respiratory medicine, and ophthalmology for “angina”, recurrent pneumonia, asthma, or persistent laryngitis, only to find that the culprit is reflux esophagitis of the digestive system. Is it enough to take medication after a doctor has diagnosed reflux esophagitis? It starts with the cause of reflux esophagitis. Reflux esophagitis is caused by a weakened barrier at the junction of the stomach and esophagus, which is unable to block the reflux of acidic gastric juices, and stomach acid is the direct cause of the symptoms. Once this structure “ages” due to age, or due to a condition called esophageal hiatus hernia, it loses its normal function and the one-way passage becomes a two-way passage and acid reflux enters the esophagus, causing symptoms. and causes symptoms. This is the most fundamental cause of reflux esophagitis, so to speak. In this way, inhibiting acid secretion is the “cure” and restoring the barrier function of the sphincter is the “cure”. For most patients, although they have reflux symptoms, the function of the “valve” is not completely destroyed, and the condition can be controlled with medication. The weakness of the esophageal sphincter due to old age, especially the presence of a hiatal hernia, is an anatomical defect that cannot be solved with medication. This is one of the reasons why many patients take medication for a long time without being able to cure the disease. Moreover, the long-term use of acid-control drugs weakens the digestive function of the stomach, causing flatulence in the stomach, which in turn further promotes acid reflux. Therefore, the diagnosis of reflux esophagitis cannot be solved blindly with drugs alone. In addition, some patients with reflux esophagitis have Barrett’s esophagus (Barrett’s esophagus), which is a precancerous lesion that may develop into esophageal cancer, and over-confidence in medication without timely surgery may delay treatment. What tests are available to analyze the function of the esophageal “valve” and the presence of a hiatal hernia? Gastroscopy can certainly detect esophageal erosion or inflammation, but many patients are discouraged by the painfulness of gastroscopy. In fact, there are simpler, more effective and less painful tests that can help clarify your condition: barium meal of the upper gastrointestinal tract and esophageal manometry. The former can clearly detect the presence of esophageal hiatal hernia, while the latter is a thin tube inserted into the esophagus to measure the pressure and peristaltic function of the esophagus and record the reflux of acid in the esophagus within 24 hours, which is the most accurate and effective tool to determine the cause and condition of reflux esophagitis. Therefore, if you have reflux esophagitis, don’t rush to take medication first, you should first have some tests done to clarify the cause and extent of reflux esophagitis so that your doctor can prescribe the right medication to help you decide whether to treat it medically or surgically. It is important to know that although medication is the basic treatment for reflux esophagitis, surgery is the only way to cure it in 20-30% of patients. You should not delay your condition because you believe too much in medication.