Acid reflux and heartburn are very common gastrointestinal symptoms. The vast majority of acid reflux and heartburn are caused by GERD, with a few caused by indigestion. The survey found that 8.16% of people in Shanghai have reflux symptoms, similar to the findings in Beijing and Xi’an. By this calculation, there are probably hundreds of millions of GERD patients in China, but the majority of people do not yet include GERD in the concept of “disease”, so many people suffer from it but do not know how to solve it. The gastric mucosa has natural resistance to stomach acid, but the esophagus and throat cannot resist the erosion of stomach acid and are easily damaged by it, resulting in symptoms such as heartburn and chest pain, and possibly esophageal chest pain, as well as chronic cough, asthma, laryngitis and other symptoms outside the esophagus, all of which fall under the category of GERD. Normal people also have occasional physiological gastroesophageal reflux once or twice, but if reflux occurs more frequently it can still cause problems in life, and over time it can also lead to inflammation, erosion, ulcers and other lesions of the esophageal mucosa, requiring intervention and treatment. What are the manifestations of gastroesophageal reflux disease? Gastroesophageal reflux disease (GERD for short) can be simply described as the feeling that there is acid back into the throat, as if there is a fire burning in the chest cavity, and that it is aggravated after meals and lying down are the characteristics of this disease. GERD also has a number of atypical symptoms that are more difficult to detect, such as hoarseness, foreign body sensation in the throat, blocked feeling in the throat, chronic cough, asthma, etc. When these symptoms occur, you need to go to a regular hospital for consultation or treatment. Treatment: medication + lifestyle adjustment】 Treatment goal: cure esophagitis, eliminate symptoms, prevent and treat complications, improve lifestyle treatment, and prevent recurrence. Drugs] The most important drugs used to treat GERD are to control gastric acid and to promote emptying. Control of gastric acid is to make the acidity of the gastric contents coming up from reflux not too strong, reduce its corrosiveness, and reduce its irritation to the esophagus to achieve the purpose of treatment. There are two types of drugs that inhibit gastric acid secretion: H2 receptor antagonists (somatidine) and proton pump inhibitors (somatrazole). Relatively speaking, proton pump inhibitors are more effective and stronger in acid suppression, and can permanently inhibit the secretion of gastric acid at the base and after stimulation. Therefore, the recommended drugs for controlling gastric acid are proton pump inhibitors, such as esomeprazole, lansoprazole, omeprazole, etc. Neutralization of gastric acid: For example, chewable magnesium aluminum carbonate tablets (Daxil), which can have a mucosal protective effect and promote the healing of esophagitis or ulcers, but these drugs tend to have a very short duration of action and are only effective for temporary symptom control. Drugs that promote gastrointestinal emptying, such as domperidone (morpholine) and mosapride, promote gastrointestinal emptying, reduce the pressure in the gastric cavity, and reduce the occurrence of reflux. Adjustment of lifestyle habits The stomach and esophagus are connected by a structure called the cardia, the entrance to the stomach, the cardia acts like a valve that can be opened or closed: when not eating, the cardia is closed, so that even when people are upside down, stomach acid and food will not flow back into the esophagus; and this valve function abnormally cannot be closed tightly, the stomach is like a vinegar bottle without a lid, lying down or abdominal pressure Gastric acid is likely to reflux into the esophagus and even the mouth, resulting in acid reflux, heartburn and a series of symptoms of gastroesophageal reflux. Therefore, from the perspective of improving the function of the “valve”, reflux can be improved by reducing the pressure in the stomach or abdominal cavity, keeping the esophagus upright, and other methods that can aggravate or recurrence of acid reflux habits should be avoided. Specifically, there are the following methods: 1. Ensure that the valve does not relax: avoid high fat, sweets, chocolate, etc., avoid alcohol and quit smoking. Eating these foods can easily lead to relaxation of the lower esophageal sphincter, which can aggravate or induce reflux. Tobacco contains nicotine, which can reduce the pressure of the lower esophageal sphincter, leaving it in a relaxed state and aggravating reflux; the main component of alcohol is ethanol, which not only stimulates gastric acid secretion, but also relaxes the lower esophageal sphincter, which is one of the causes of gastroesophageal reflux. 2, reduce the pressure of the stomach cavity or abdominal cavity: pay attention to a small number of meals, each meal should not be too full, eat a low-fat diet, can reduce the frequency of reflux symptoms after eating. Obese people should reduce their weight. Because the increased abdominal pressure in overly obese people can promote the occurrence of gastric reflux, especially more serious in the horizontal position, weight should be actively reduced to improve reflux symptoms. Minimize activities that increase intra-abdominal pressure, such as excessive bending, wearing tight-fitting clothes and pants, tightening the belt, etc. 3, keep the esophagus upright: avoid lying down immediately after meals. The overall head of the bed should be raised 10 cm to 15 cm at bedtime, which is a proven way to reduce nighttime reflux. Some friends will also encounter a problem of recurrent symptoms: patients without esophagitis can be considered for on-demand maintenance therapy, i.e., medication when symptoms are present and discontinuation when symptoms disappear. To achieve immediate symptom control medication, esomeprazole is recommended as the most satisfactory. To prevent complications caused by recurrence of esophagitis, maintenance therapy may be given. The dose of maintenance therapy varies from patient to patient, and the appropriate dose is adjusted to the lowest dose at which the patient is asymptomatic, usually at half the original therapeutic dose, in order to achieve control of reflux symptoms. A follow-up visit for medication adjustment or further examination is recommended if no effect is seen for one week. Although most people’s symptoms of acid reflux and heartburn can be relieved or disappear completely with the help of doctors, objective facts tell us that GERD is a chronic recurrent disease and there is no method at home or abroad that can completely cure the disease (so that it will not recur). We should look at the disease rationally and change the idea of “once and for all”. Therefore, it is very important to adjust the living habits and diet. Avoid high-fat, high-sugar, and food that you think will aggravate your reflux, do not eat before bed, eat fewer meals, control your weight, be in a good mood, try to quit smoking and drink less alcohol, in fact, these habits are themselves promoted healthy lifestyle, so why not do it.