1. Ignore the fact that there are individual differences in medication use. For most patients, a once-daily dose of a proton pump inhibitor (a strong acid suppressant) can effectively control esophageal acid reflux. However, some patients have “evening acid breakthrough” (heartburn, chest pain and acid belching symptoms that occur between midnight and 6 a.m.). In these patients, such medication does not solve the problem. Proton pump inhibitors in these patients may be metabolized faster than the average person, then, it is necessary to add a proton pump inhibitor in the evening or H2 receptor inhibitor before bedtime. 2, neglect to effectively protect the damaged esophageal mucosa. Has been damaged esophageal mucosa need to repair and protection. Aluminum thiosulfate or aluminum magnesium carbonate preparations can effectively protect the esophageal mucosa, but pay attention to the use of methods. These drugs should not be taken in large quantities with water, but should be distributed evenly to the esophageal mucosa in a gel form, with the help of its own gravity and esophageal peristalsis. In addition, in the treatment of esophagitis, it is advisable to take these drugs half an hour after a meal, which will be more conducive to the stay of the drug in the esophagus and play a protective and restorative role. This is different from the regular use of the drug instructions. 3, ignore the use of pro-gastric power drugs. Some patients think that as long as they strongly stop the secretion of gastric acid, they can reduce acid reflux and eliminate esophageal inflammation, so they can just use strong acid suppressants. In fact, acid reflux is not caused by stomach acid, but other components of the gastric juice including bile refluxed from the duodenum into the gastric juice are also the cause of esophagitis. Gastric stimulants play an important role in maintaining pressure in the lower esophageal high-pressure band. Although some patients experience mild abdominal pain and diarrhea when gastroprokinetic drugs are first administered, most patients tolerate them. It will disappear with continued medication or dose adjustment. 4, neglect to eradicate H. pylori at the appropriate time. Many patients with reflux esophagitis, when they know they have H. pylori infection at the same time, they strongly urge their doctors to eradicate it immediately. Unbeknownst to them, H. pylori produces ammonium, which has the effect of neutralizing the local acid environment at the esophageal junction of the fundus of the stomach and may reduce the corrosion of the esophagus by acid. Instead, immediate eradication of H. pylori may aggravate acid reflux. Therefore, the appropriate time to kill H. pylori should be chosen after the basic control of esophagitis. 5, ignore the impact of systemic diseases. Gastrointestinal motility is affected by many factors, such as diabetes, scleroderma can slow down the emptying of the esophagus and stomach, aggravating acid reflux; the presence of diaphragmatic hernia makes the subesophageal high-pressure band disappear, even with the use of pro-gastric power drugs, it is difficult to restore. At this point, reflux esophagitis is very difficult to cure without effective treatment for these primary diseases. 6, ignore the impact of lifestyle habits. Some patients smoke, drink alcohol, eat a lot of vinegar or drink strong tea and coffee during treatment as usual. Other patients are too full for dinner and have to eat late night snacks. Some patients like to drink milk before going to bed. Some patients do not sleep with the head of the bed elevated 30 degrees, all of which gives the opportunity for acid reflux to take advantage of. In conclusion, there are many reasons for the unsatisfactory treatment of reflux esophagitis, and patients should be careful and specific in their analysis and targeted treatment.