Gastroesophageal reflux disease is a disease that occurs due to the reflux of stomach and duodenal contents into the esophagus, and it includes both cases of broken and unbroken esophageal mucosa. The main discomforts of these patients are: retrosternal discomfort, pain, heartburn, acid reflux, pain in the throat or difficulty in swallowing, and in some patients, recurrent asthma, cough, nocturnal apnea and pharyngitis. Gastroesophageal reflux disease is mainly due to gastric contents (mainly gastric acid, a few will have bile salts) from gastric reflux into the esophagus, resulting in irritation of the esophageal mucosa as well as clinical symptoms of damage, therefore, the standard Western medical treatment mainly includes three aspects of drugs: 1, acid-control drugs: the main purpose is to reduce the acidity of the stomach, so that the reflux up to reduce the irritation of the esophagus, commonly used drugs for PPI class Acid control drugs, including omeprazole, lansoprazole, rabeprazole, etc. 2, power drugs: the main purpose is to increase the emptying capacity of the esophagus, to counter reflux, reduce the retention time of reflux in the esophagus, commonly used drugs for gastrointestinal power drugs, including morpholine, moxaburi, etc. 3, mucosal protective agent: mainly against gastric acid as well as the desire to form a protective film at the site of esophageal damage, common drugs are Daxi, aluminum magnesium plus suspension, etc. There is a special situation, some patients with this disease in the consultation of the various tests are normal, but patients insist that they have the symptoms of the disease when it occurs, what is going on? Such patients do have similar disease symptoms in terms of clinical symptoms, but a careful analysis reveals that there are many differences compared to the typical symptoms, which include: 1. The time of occurrence. As reflux is the process of stomach and duodenal contents reaching up to the esophagus, so the occurrence of reflux is generally related to eating, eating too fast, too full when the abdominal pressure rises, easy to appear reflux, while fasting is not easy to appear reflux; In addition, the occurrence of reflux is also related to the location of the esophagus, sitting, standing, walking during the day is located on top of the stomach, food due to the role of gravity is not easy to reflux, while At night, when lying down, the relative position of the esophagus and the stomach becomes flat and sometimes the position of the stomach is even higher than the esophagus, which will aggravate the reflux, so generally reflux occurs more at night, especially late at night, and many patients will wake up during sleep because of chest pain or cough caused by reflux; and although such patients have symptoms of reflux, the time and characteristics of the occurrence are exactly the opposite of gastroesophageal reflux disease. Therefore, it is not similar from the time of occurrence. 2. Duration. In normal people, the contents of the stomach and duodenum cannot be endlessly refluxed, so the symptoms caused by reflux are generally paroxysmal, while such patients are continuously uncomfortable, which is not in line with the real symptoms of the disease. Where do these patients get the feeling of disease? It is not an empty feeling, it comes from the patient’s psychology. Because of the long duration of GERD and the frequent recurrence of symptoms during treatment, 30% of patients also experience more or less worry and anxiety about the disease, so it is sometimes difficult for doctors to distinguish between anxiety caused by the disease and similar symptoms caused by anxiety. To really know if it is a symptom of the disease, the distinction can be made by esophageal manometry and 24-hour acid (base) measurement tests. If the test is abnormal, the disease should be treated first even if there is anxiety, and generally the anxiety will improve significantly after the disease is effectively treated; if the test is normal, the patient’s symptoms originate from the psychology and his or her abnormal feelings, and then psychotherapy should be the main focus instead of continuing treatment for GERD. In addition, because this disease is sometimes accompanied by anxiety, there are also gastroenterologists who will give anti-anxiety treatment on top of standard treatment, commonly used drugs include Prozac, Dexedrine, etc. However, such drugs are generally auxiliary drugs and can be gradually reduced and discontinued after the reflux situation improves. If the patient’s symptoms recur immediately after discontinuation, consider that the main focus is on psychological problems.