Gastroesophageal reflux disease (GERD) is a clinical syndrome characterized by heartburn and acid reflux caused by the reflux of gastric and duodenal contents into the esophagus. In the past, NERD was considered to be a lighter form of RE, and GERD progressed from NERD to RE and then to Barrett’s esophagus. In the past, NERD was thought to be a milder form of RE, and GERD progressed from NERD to RE and then to Barrett’s esophagus (BE) and esophageal adenocarcinoma. There is no evidence to support the progression of NERD to RE, nor can it be proven that BE evolves from RE or NERD. Etiology: Mao Hua, Department of Gastroenterology, Zhujiang Hospital, Southern Medical University Gastroesophageal reflux disease is the result of decreased anti-reflux defense mechanism of the esophageal cardia and increased attack of refluxed material on the esophageal mucosa. normally, the lower esophageal sphincter (LES) pressure exceeds the high pressure band of gastric internal pressure, which can prevent reflux of gastric contents into the esophagus. when the LES pressure decreases and the septal pressure difference increases due to increased intra-abdominal pressure can induce the development of this disease. among them. transient LES relaxation (TLESR) plays an important role in the pathogenesis. In addition, hiatal hernia, delayed gastric emptying, impaired esophageal peristalsis or decreased clearance are also associated with the development of NERD, and in some cases with increased esophageal sensitivity and psychiatric and psychological disorders. It has been suggested that gastric body gastritis due to H. pylori infection may cause atrophy of the gastric glands leading to a decrease in acid and pepsin, and neutralize gastric acid through ammonia production, while protecting patients prone to GERD.