In the dream, the mouth contains “sour grapes” after a full meal, want to sleep beautifully, but just lying down, but feel the chest burning, mouth acid, as if the mouth contains a sour grape. Sometimes, I even wake up at night suddenly choking on acid and coughing frequently, but I feel better when I sit up. Recently, this situation often plagued the increasingly “blessed” old Zhang. Zhang was worried: What is this strange problem? He went to the cardiology, respiratory, ear, nose and throat departments, but no obvious abnormalities were found. Finally, he came to the gastroenterology department. The doctor suggested him to perform esophageal manometry and 24-hour dynamic pH monitoring, which showed that the lower esophageal sphincter pressure was significantly lower and there was obvious pathological acid reflux. Combined with the symptoms, the doctor concluded that Zhang had “GERD” and recommended that he change his lifestyle and take medication. What makes Zhang feel “sour” from time to time? Under normal circumstances, the stomach acid secreted in the human stomach mixed with food, through the duodenum into the small intestine. There are several “imperial guards” at the connection between the esophagus and the stomach to prevent acid reflux, including the lower esophageal sphincter, the septum, and the septal esophageal ligament. If these guardians fail to perform their duties, especially the lower esophageal sphincter, gastroesophageal reflux will result. So, what makes the “guardian of the front door” remove its armor? The first is cardia surgery, which causes structural damage to the lower esophageal sphincter. Secondly, certain hormones (cholecystokinin, glucagon, etc.), high-fat foods, and medications (e.g., calcium antagonists, valium) cause a decrease in lower esophageal sphincter pressure. In addition, intra-abdominal pressure and intragastric pressure exceeding the lower esophageal sphincter pressure can also cause gastroesophageal reflux. The gastric acid, pepsin and bile in the reflux irritate the esophageal mucosa and even irritate the throat causing acid reflux, heartburn, nausea, chest pain and sleep disorders, and sometimes cough, asthma and laryngitis. Some patients with typical symptoms such as acid reflux, heartburn and chest pain may not be obvious, but only show atypical symptoms such as cough, asthma and hoarseness, and they are often transferred to the five departments, such as respiratory medicine and cardiology, and cannot get timely treatment for a long time. There are many ways to keep stomach acid at home, such as lifestyle changes, medication and surgery. Which is better or worse, or let them compare. 1, change the lifestyle As obesity can make the intra-abdominal pressure increase, thus inducing or aggravating acid reflux, so obese people should reduce weight. Avoid eating or drinking 4 hours before bedtime, and should not lie down immediately after meals. Try to smoke less, drink less alcohol, strong tea, coffee, and eat less high-fat food to avoid lowering the pressure of the lower esophageal sphincter. It is important to avoid full meals, tight girdles, and active treatment of constipation, chronic cough and other diseases that tend to cause increased abdominal pressure. Exercise can help digestion, reduce the accumulation of food in the stomach and reduce the chance of esophageal reflux. 2.Medication Generally, acid suppressants and gastrointestinal stimulants are used. The “culprit” of GERD is gastric acid. Acid suppressants reduce the secretion of gastric acid by inhibiting it from “flooding” into the esophagus or pharynx, thus eliminating heartburn, acid reflux, chest pain and other symptoms. Proton pump inhibitors and H2 receptor blockers are commonly used. In addition, pro-gastrointestinal dynamics drugs such as domperidone can promote gastric emptying, as if the floodgates of the reservoir to reduce the pressure of reflux, can be used as an adjuvant therapy for the disease. 3.Surgical treatment includes gastroscopic surgery and surgery, mainly the repair of fundic folding and esophageal hiatal hernia. Because of the invasive nature, surgical treatment is only applicable to patients with clear organic lesions and ineffective drug treatment. Gastroesophageal reflux disease is often recurring after treatment and discontinuation of medication. Therefore, it is important to maintain a good lifestyle and diet even after symptoms have improved with treatment. Medication should be standardized, and those with severe disease, such as esophageal ulcer and esophageal stricture, need a long course of maintenance treatment. For patients with reflux symptoms but not associated with esophagitis, maintenance therapy can be adopted on an as-needed basis, i.e., take medication when symptoms occur and stop when they improve and stabilize, so that good health can be maintained and the use of medication can be reduced. In addition, for patients with complications (esophageal ulcer, stricture), follow-up should be strengthened and gastroscopy should be reviewed when necessary for early detection of precancerous lesions and early esophageal cancer and timely treatment.