1. What is gastroesophageal reflux? Who is prone to GERD? Under normal circumstances, due to the function of the lower esophageal sphincter at the gastroesophageal junction, food and gastric juice entering the stomach do not easily reflux into the esophagus, but enter the duodenum through the pylorus under the effect of gastric emptying. However, in some patients, due to the dysfunction of the lower esophageal sphincter, gastric juices often reflux into the esophagus repeatedly, and even reflux to the pharynx. This disease is not uncommon in the population, and its incidence is reported to be as high as 50% abroad. There are no accurate statistics on the incidence in China, but in recent years, with the improvement of living standards, the change of diet structure, the increasing number of obese people, the incidence is also gradually increasing, but patients generally do not pay enough attention to the majority of formal medical consultation and take medication on time. 2.What are the symptoms of gastroesophageal reflux? How to confirm the diagnosis of GERD? The typical symptoms include “heartburn” and “acid reflux”, which usually worsen after meals or when lying down, or after eating certain foods such as high-fat diet, chocolate, coffee and alcoholic beverages. Other atypical symptoms include throat discomfort, chronic cough, recurrent pneumonia, retrosternal pain, asthma, hoarseness, and in severe cases, dysphagia, painful swallowing, vomiting blood, and black stools. The gold standard for GERD diagnosis is the 24-hour pH test. However, because it requires the insertion of a pH monitoring electrode from the patient’s nasal cavity, placed 5 cm above the lower esophageal sphincter, and continuous monitoring for 24 hours, it is more difficult for many patients to accept. Therefore, for many patients with typical symptoms, this test is not necessary. Other tests include upper gastrointestinal imaging, electronic gastroscopy and esophageal function testing, which are mainly used to clarify the presence of comorbidities such as esophageal hiatal hernia, short esophagus, peptic ulcer, esophageal stricture, and to exclude malignant tumors of the esophagus or stomach. 3.What are the treatment techniques for GERD? Gastroesophageal reflux is generally treated in a step-by-step manner, starting with changing poor dietary and lifestyle habits, then using acid-suppressing drugs if they are ineffective, or giving double doses if necessary. surgical treatment should be considered. Surgery should also be considered for patients with severe esophagitis, Barrett’s esophagus, or short esophagus. At present, surgery is mainly performed by laparoscopic minimally invasive anti-reflux surgery, which can be done by making only 4-5 incisions of about 5 mm in the abdomen, and 90% of the patients worldwide have achieved better results. 4.Why should I see cardiothoracic surgery for GERD? What are the dangers of long-term untreated GERD? Long-term untreated GERD may cause recurrent esophageal inflammation or even esophageal ulcer, leading to esophageal stricture and affecting swallowing function, and in severe cases, short esophagus may occur. In addition, long-term recurrent esophageal inflammatory stimulation can lead to columnar epithelial hyperplasia of esophageal squamous epithelium, also called Barrett’s esophagus, which is a precancerous lesion and more than 70% of esophageal cancers in Europe and America evolve from this disease. Therefore, for patients with GERD symptoms, we strongly recommend that they should first consult the gastroenterology department. If the symptoms are not significantly relieved by conservative treatment, or if the above-mentioned comorbidities are already present, they should promptly go to the thoracic surgery department for evaluation and, if necessary, surgical treatment. 5.How do patients need to cooperate with doctors in the treatment of GERD? The most important treatment for GERD is to change poor diet and lifestyle habits, such as reducing the intake of fat, caffeine, alcohol and tobacco, regular diet and life, exercise and weight loss, and not lying down or sleeping within 2-3 hours after meals. For patients who need medication, they need to take the medication regularly and review it regularly according to the doctor’s prescription.