Lili is a white-collar older woman, the last 2 weeks often acid reflux into the mouth, whether the acid is spit out or swallowed again, the feeling is particularly uncomfortable, especially when bending over to do things. She often sees women on TV with acid reflux for no reason, running to the bathroom and throwing up, which easily makes people think of pregnancy. Lili went to the hospital early in the morning and asked anxiously as soon as she entered the consultation room, “Doctor, I often have acid reflux after drinking coffee, red wine or eating chocolate in the past 2 weeks, and sometimes I have a heartburn-like feeling. The doctor asked for a detailed medical history, menstruation and sex life, and then issued a test sheet for her to go for a urine test. Half an hour later, Lili came back with the test report, and the doctor said after reading it, “You are not pregnant, although you usually have menstrual disorders, but now the urine pregnancy test is negative, and, early pregnancy reaction refers to acid reflux, nausea or vomiting in early pregnancy (about 6 weeks after menopause), more so in the morning, and may be accompanied by dizziness, weakness, drowsiness, change in appetite, etc.. “ Lili still asked uneasily, “Doctor, what is wrong with my acid reflux? What disease do I have?” The doctor explained, “Acid reflux refers to the reflux of stomach contents, mainly stomach acid, through the esophagus to the oropharynx, the mouth feels the appearance of acidic irritating substances, it is sometimes accompanied by duodenal contents (such as bile, etc.) through the stomach, esophagus reflux to the oropharynx, the mouth feels the appearance of bitter substances, collectively referred to as reflux. Acid reflux can cause heartburn-like discomfort or chest pain, painful swallowing, difficulty swallowing, and respiratory symptoms (e.g., cough, asthma, etc.). Many diseases can cause acid reflux, such as esophagitis, gastroesophageal reflux disease (including reflux esophagitis and non-erosive reflux disease), esophageal hiatal hernia, esophageal cancer, gastroparesis syndrome, functional dyspepsia, peptic ulcer, and gastric cancer. In addition to these diseases, acid reflux can also be caused by taking certain drugs, such as anticholinergic drugs (e.g. atropine, belladonna combination, etc.), b-agonists (e.g. isoproterenol, etc.), theophylline or anandamide, tranquilizers, calcium channel blockers (isoptin, nipradipine, etc.), nitroglycerine preparations, opiates, etc. In addition, the occasional occurrence of acid reflux when smoking, drinking alcohol, coffee, eating chocolate and greasy or during menstruation is called physiological acid reflux. As for your case, you have gastroesophageal reflux disease.” Lili asked in disbelief, “I am not pregnant, what is causing the acid reflux? What tests do I need to do?” The doctor said, “Because you usually like to drink coffee and red wine and eat chocolate and durian, these things can cause acid reflux due to dysfunction of the stomach and the peristalsis of the stomach and esophagus. You need a gastroscopy of the upper gastrointestinal tract to clarify whether there are lesions in the esophagus, stomach and duodenum, and to distinguish endoscopically whether it is reflux esophagitis or non-erosive reflux disease, with intraesophageal manometry and 24-hour acidity (pH) monitoring if available.” Lili asked nervously, “Can GERD become cancerous? Is there a way to prevent it?” The doctor said, “If esophagitis is severe or recurrent for a long time, it will cause moderate to severe atypical hyperplasia of esophageal mucosal cells or when Barrett’s esophagus occurs, the risk of developing esophageal cancer is greatly increased. The way to prevent it is to standardize treatment and review gastroscopy regularly until esophagitis is completely cured.” Lili asked fearfully, “Doctor, I heard that gastroscopy is very painful, I am afraid to do it, is there any other way?” The doctor smiled and said, “Gastroscopy is not painful, but there will be vomiting, as long as you relax during the gastroscopy and spray some mucosal surface anesthetic in the throat, most people can tolerate, individual panic, can do sedation gastroscopy or anesthesia gastroscopy. If all these tests are unwilling to do, barium meal examination of esophagus can be done, but small lesions of mucosa are not easy to find and tissue biopsy cannot be done, once lesions are found, gastroscopy and tissue biopsy are still needed; in addition, for young patients, obvious causative factors, no alarm symptoms (such as vomiting blood, black stool, anemia, wasting, etc.) and family history of gastrointestinal tumor, proton pump inhibitors can be applied for therapeutic diagnosis, such as Omeprazole 20mg twice a day for 7 days, if the symptoms are obviously improved, gastroscopy can be temporarily not done and the treatment should be continued, once the condition worsens or when swallowing difficulty occurs, gastroscopy should be done.” Lili followed up, “Doctor, how do I need to be treated? How long does it take to treat?” The doctor said patiently, “If you have occasional acid reflux, and the symptoms can be relieved after you quit the above-mentioned drinks and snacks, you may not need medication; if the acid reflux is frequent with heartburn-like chest pain, standardized treatment should be carried out, and the measures include the following aspects.” 1. Non-pharmacological treatment 1. The pillow should be elevated when sleeping to prevent reflux when lying down; avoid eating within 2 hours before going to bed, and should not lie down immediately after eating during the day, and should eat 5-6% of each meal, and eat less and more meals. 2, should avoid eating high fat and spicy food, chocolate, coffee, strong tea, durian, mango, etc., should stop smoking and alcohol. 3, pay attention to eliminate all factors that can increase abdominal pressure, such as obesity, constipation, belt tightening, etc.. 4, should avoid taking the above-mentioned drugs to avoid aggravating reflux. Second, drug treatment: after the above treatment still have symptoms, should be added with drug treatment, the course of treatment 2-3 months. 1. H2 receptor antagonist: such as cimetidine, ranitidine, famotidine, etc. 2. Proton pump inhibitors: such as omeprazole, lansoprazole, rabeprazole, esomeprazole, etc. 3. Drugs to neutralize stomach acid: Vetimax, Daxil tablets, etc., can quickly relieve symptoms. 4. Gastrointestinal prokinetic drugs: the most widely used are morpholine and mosapride, which can accelerate the emptying of the esophagus and stomach and reduce reflux. With the above treatment, the vast majority of patients can get good results and generally do not need surgical treatment.