Gagging sensation is the discomfort of swallowing with choking pain caused by a variety of factors irritating the esophagus. It is mostly seen in esophagitis, esophageal carcinoid tumor, etc. It is mostly seen in esophagitis, where the esophageal mucosa becomes edematous and congested due to abnormal stimulation. These stimuli are stomach acid, bile coming up from duodenal regurgitation, strong alcohol, chili, too hot vegetable soup, too strong and hot tea, etc. So, what should be the basis for diagnosing whether the patient is choking painful sensation? The following is a brief description of the diagnostic basis: When you feel “heartburn”, or “heartache”, or pain behind the sternum when drinking hot water or eating irritating food, these are all symptoms of esophagitis. The reason why you feel choking when swallowing food is due to esophageal edema, narrowing of the esophagus or spasmodic contraction of the esophageal wall due to inflammatory stimulation. Esophagitis should be treated promptly, otherwise it may deteriorate to the point of developing esophageal mucosal ulcers and vomiting blood or blood in the stool. It can also be seen in esophageal carcinoid tumors, mostly in men aged 26-77 years, with an average age of 54 years. The main symptom is discomfort or choking pain behind the sternum when swallowing, and severe swallowing obstruction is rarely seen. Because carcinoid tumor is a tumor that produces small molecule peptide or amine hormone and secretes 5-hydroxytryptamine, histamine, kinin and other bioactive substances, patients may have clinical manifestations of carcinoid syndrome such as facial flushing, diarrhea, asthma and edema; when liver metastasis occurs, the 5-hydroxytryptamine (5-HT3) secreted by carcinoid tumor can directly enter the hepatic vein without inactivation by monoamine oxidase in the liver, which increases the concentration of 5-HT3 and causes symptoms. concentration increases and causes symptoms.