GERD, which should be called gastroesophageal reflux disease (GERD), triggers coughing and is one of the common symptoms, with moderately severe patients being more prone to choking due to high levels of reflux. GERD causes coughing because of the dysfunction of the lower esophageal sphincter, which leads to acid reflux. When the patient’s body position changes or during exercise, the sphincter is unable to prevent the contents of the stomach and duodenum from refluxing along the esophagus, which then travels upward to irritate the throat, causing inflammation or spasm of the airway mucosa and triggering a cough. The cough is mostly a paroxysmal, irritating dry cough that worsens especially after meals and at night when gastric acid secretion is high. In patients with moderate to severe GERD, the reflux is severe and the coughing is frequent, making them susceptible to choking and progressing to aspiration pneumonia. It is recommended that patients with the symptoms described in the question avoid lying down and strenuous exercise after eating. If the patient has severe reflux symptoms or coughs frequently and is prone to choking, he/she should go to the hospital in time for treatment under the guidance of a doctor.