Drug treatment of GERD is mainly achieved by inhibiting gastric acid secretion, which is secreted by the gastric lining cells and achieved by moving potassium ions from the gastric lumen into the lining cells and hydrogen ions into the gastric lumen through the proton pump. Proton pump inhibitors (PPIs) inhibit gastric acid secretion by blocking this process through the inhibition of the proton pump. Proton pump inhibitors are absorbed through the duodenum after oral administration and can be selectively concentrated in the acidic environment of the gastric lining cells, where they can remain for 24 hours, with specific and selective action and fewer side effects. Although PPI has less side effects, there are still side effects, about less than 2% of patients have side effects such as headache, diarrhea and indigestion. The main side effects of long-term use are: 1, atrophic gastritis, gastric polyps Long-term use of PPI can lead to glandular atrophy, atrophic gastritis, gastric polyps, such as to avoid the side effect or reduce the chance of occurrence, can be taken orally at the same time, such as Rebaipate tablets, teprenone capsules and other drugs that promote endogenous prostaglandin synthesis and improve gastric circulation and protect the gastric mucosa, such as atrophic gastritis has appeared, can also be taken through the drug Treatment to reverse or prevent further development of gastric polyps can be endoscopically clamped, argon ion coagulation, ligature, submucosal peeling or excision treatment. 2, affect the absorption of trace elements including calcium ions, magnesium ions, etc. Such as long-term use of PPI, through the blood ion analysis, found low calcium, low magnesium or appear low calcium, low magnesium symptoms, exclude other diseases leading to low calcium, low magnesium, etc., can be improved by oral calcium and magnesium preparations; but there are still some patients can not improve. 3, lead to hip, wrist and other parts of osteoporosis But lead to fracture risk increase chance is not large, if there is no other lead to fracture risk, can take long-term. 4.Leading to dysbiosis of the upper jejunum, increased chance of Clostridium difficile infection, diarrhea and other symptoms Long-term use of PPI will reduce the acidity of gastric juice entering the duodenum and jejunum from the stomach, causing dysbiosis, which can be treated with oral intestinal probiotics or antibacterial drugs. 5.Increase the chance of infection of community-acquired pneumonia Presumably the mechanism of occurrence may be related to the reduction of the barrier mechanism of gastric acid after taking PPI, but there is no increase in the chance of infection in long-term patients who have been taking PPI for more than 2 months. 6. Reduced efficacy of anti-platelet drugs such as clopidogrel Since PPI and clopidogrel are both metabolized in the liver through cytochrome P450 (CYP 2C19) enzymes, both of them are competitively inhibited. The combined application of PPI and clopidogrel mechanistically leads to a reduction in the active metabolites of clopidogrel, making its anti-platelet effect weaker and causing an increased incidence of cardiovascular adverse events. For patients taking clopidogrel at the same time can take less through the cytochrome P450 (CYP 2C19) enzyme metabolism of pantoprazole, rabeprazole treatment, there are also recent reports that esomeprazole effect is also less. 7, may affect the absorption of VitB12 Theoretically, gastric acid can promote the dissolution of protein in food and promote the release of VitB12, the inhibition of gastric acid will affect the absorption of VitB12, but through clinical observation, there is no difference between patients with reduced blood VitB12 levels and patients without reduced homocysteine levels and mean red blood cell volume in patients taking long-term PPI. 8, increase the chance of other bacterial infections: Due to the effect of gastric acid, it is difficult for bacteria other than H. pylori to survive in the stomach. After the application of proton pump inhibitors, with the reduction of acidity in the stomach, it increases the chance of bacteria and other microorganisms to survive in the stomach, and these bacteria will promote the conversion of nitrate to nitrite, which may increase the chance of gastric cancer. Anti-reflux drugs mainly include acid suppressants and acid preparations, and acid suppressants mainly include PPI and histamine H2 receptor antagonists, with omeprazole and ranitidine as representative drugs. Since histamine H2 receptor antagonists act at the beginning stage of acid production and PPI acts at the final stage, the binding of PPI and proton pump is irreversible until the wall cell dies, so there is no need to use histamine H2 receptor antagonists after PPI. Acid suppressants are represented by magnesium aluminum carbonate tablets (Daxi), which are not absorbed and mainly play a neutralizing effect on acid and adsorption of bile, and the combination of these drugs should be avoided when taken at the same time to avoid affecting the absorption of PPI, PPI should be taken on an empty stomach, but rabeprazole is not required and can be taken before and after meals. Treatment of GERD sometimes proton pump inhibitors are applied simultaneously with drugs that adjust or enhance gastric motility such as trimethoprim and morpholine, and there is no antagonism between proton pump inhibitors and these drugs, which can be applied simultaneously. The basic medication for GERD is PPI, which usually requires long-term medication. If you do not want to take medication for a long time, or if you are worried about side effects, you can choose micro-current radiofrequency treatment for esophagus or minimally invasive laparoscopic surgery to achieve the purpose of not taking medication or reducing medication.