Drug treatment of GERD is mainly achieved by inhibiting gastric acid secretion, which is secreted by the gastric lining cells and achieved by moving potassium ions from the gastric lumen into the lining cells and hydrogen ions into the gastric lumen through the proton pump. Proton pump inhibitors (PPIs) are able to inhibit gastric acid secretion by blocking this process through the inhibition of the proton pump. Proton pump inhibitors are absorbed through the duodenum after oral administration and can be selectively concentrated in the acidic environment of the gastric lining cells, where they can remain for 24 hours, with specific and selective action and fewer side effects. Although PPI has less side effects, there are still side effects, about less than 2% of patients have side effects such as headache, diarrhea and indigestion. The main side effects of long-term use are: 1. Atrophic gastritis and gastric polyps. Long-term use of PPI will lead to glandular atrophy, atrophic gastritis, gastric polyps, such as to avoid the side effects or to reduce the chance of occurrence, can be accompanied by oral Rebapet tablets, Teprenone capsules and other drugs that promote endogenous prostaglandin synthesis and improve gastric circulation, protection of gastric mucosa, such as atrophic gastritis, can also be reversed or prevented from further development by taking medication, gastric polyps can be endoscopic clamp removal 2, affecting the absorption of trace elements including calcium ions, magnesium ions, etc. Such as long-term use of PPI, through the blood ion analysis, found low calcium, low magnesium or appear low calcium, low magnesium symptoms, exclude other diseases leading to low calcium, low magnesium, etc., can be improved by oral calcium, magnesium supplementation preparations; but there are still some patients can not improve. 3, leading to osteoporosis of the hip, wrist and other parts. However, it has little chance of leading to increased risk of fracture, and can be taken for a long time if there is no other risk of leading to fracture.4. It leads to dysbiosis of the upper jejunum, increased chance of Clostridium difficile infection and diarrhea and other symptoms. Long-term use of PPI, from the stomach into the duodenum, jejunum gastric juice acidity is reduced, causing dysbiosis, can be treated with oral intestinal probiotics or antibacterial drugs. 5, increase the chance of infection of community-acquired pneumonia, presumably the mechanism of occurrence may be related to the reduction of the barrier mechanism of gastric acid after taking PPI, but there is no increase in the chance of infection in long-term patients taking it for more than 2 months. 6, reduce clopidogrel and other Antiplatelet drugs efficacy. Since PPI and clopidogrel are both metabolized in the liver through cytochrome P450 (CYP 2C19) enzymes, both of them are competitively inhibited. The combined application of PPI and clopidogrel mechanistically leads to a reduction in the active metabolites of clopidogrel, making its anti-platelet effect weaker and causing an increased incidence of cardiovascular adverse events. For patients taking clopidogrel at the same time can take less through the cytochrome P450 (CYP 2C19) enzyme metabolism of pantoprazole, rabeprazole treatment, also recently reported that esomeprazole effect is also less.7, may affect the absorption of VitB12. Theoretically, gastric acid can promote the dissolution of protein in food and promote the release of VitB12, and the inhibition of gastric acid will affect the absorption of VitB12, but through clinical observation, there is no difference between patients with reduced blood VitB12 levels and patients without reduced homocysteine levels and mean red blood cell volume in patients taking PPI for a long time.8, increase the chance of other bacterial infections: due to the effect of gastric acid, the stomach After the application of proton pump inhibitors, with the decrease of acidity in the stomach, it increases the chance of survival of bacteria and other microorganisms in the stomach, and these bacteria will promote the conversion of nitrate to nitrite, which may increase the chance of gastric cancer. Anti-reflux drugs mainly include acid suppressants and acid preparations, and acid suppressants mainly include PPI and histamine H2 receptor antagonists, with omeprazole and ranitidine as representative drugs. Since histamine H2 receptor antagonists act at the beginning stage of acid production and PPI acts at the final stage, the binding of PPI and proton pump is irreversible until the wall cells die, so there is no need to use histamine H2 receptor antagonists after PPI. Acid suppressants are represented by magnesium aluminum carbonate tablets (Daxi), which are not absorbed and mainly play a neutralizing effect on acid and adsorption of bile, and the combination of these drugs should be avoided when taken at the same time to avoid affecting the absorption of PPI, PPI should be taken on an empty stomach, but rabeprazole is not required and can be taken before and after meals. Treatment of GERD sometimes proton pump inhibitors are applied simultaneously with drugs that adjust or enhance gastric motility such as trimethoprim and morpholine, there is no antagonism between proton pump inhibitors and these drugs, and they can be applied simultaneously. The basic medication for GERD is PPI, which usually requires long-term medication.