Gastroesophageal reflux disease (GERD) is a disease in which the reflux of gastric contents into the esophagus causes uncomfortable symptoms and/or complications as a result of a combination of weakened anti-reflux defense mechanisms and attack of reflux on the esophageal mucosa. Clinical symptoms Heartburn and/or reflux are the most typical symptoms of GERD, while retrosternal pain, epigastric burning sensation and belching are atypical symptoms of GERD. Diagnosis Proton pump inhibitor (PPI) test (taking a standard dose of PPI, such as omeprazole 20mg2/day for 1 to 2 weeks) can be used as a preliminary diagnosis of GERD. If the patient’s symptoms disappear or improve significantly after taking the drug then the PPI test is positive and supports the diagnosis of GERD. Gastroscopy, upper gastrointestinal imaging, esophageal manometry and 24-hour pH monitoring are commonly used tests. Treatment 1.Lifestyle modification Lifestyle changes such as weight loss, smoking/alcohol cessation, avoiding eating before bedtime, elevating the head of the bed, etc., of which body position is an effective method to reduce reflux. 2.Medical treatment PPI is the drug of choice for GERD treatment, single dose PPI treatment is ineffective can be changed to double dose, one PPI is ineffective can try to switch to another PPI. PPI treatment course is at least 8 weeks. However, there is evidence that the long-term application of PPI raises the pH in the stomach, which can promote the proliferation of intestinal flora, thus increasing the risk of Clostridium difficile infection. 3.Endoscopic treatment Among the endoscopic treatment methods, radiofrequency treatment and transoral non-incisional fundoplication (TIF) are the hot spots of research in recent years. Some experts believe that this method reduces the sensitivity of esophageal mucosa to acid reflux and leads to symptom reduction, but the anti-reflux effect is uncertain and the long-term efficacy still needs to be confirmed by further studies. 4.Surgical treatment Anti-reflux surgery is another treatment option for patients who require long-term medication despite effective PPI treatment. failure of PPI treatment is one of the indications for anti-reflux surgery. Anti-reflux surgery can reduce the number of reflux and control reflux symptoms. The most commonly used anti-reflux surgery procedure is laparoscopic fundoplication, which is performed laparoscopically to increase the pressure in the lower esophagus by minimally invasive treatment means and to achieve the purpose of anti-reflux, after which patients can stop taking PPI medications and have good long-term follow-up results once and for all.