The common causes of choking awake at night with acid reflux include physiological or pathological causes, and usually this symptom can be relieved by general treatment and medication under the guidance of a doctor. Common causes of choking awake at night with acid reflux and treatment are as follows: a. Physiological causes of neuroexcitation: parasympathetic excitation at night during sleep state, lower esophageal sphincter relaxation, pressure reduction, the secretion of gastric acid in the recumbent position is easy to reflux through the lower esophageal sphincter and into the esophagus, which leads to acid reflux at night. It can be treated medically, such as taking proton pump inhibitors to inhibit the secretion of gastric acid for relief, and common drugs include omeprazole, rabeprazole, etc. Second, pathological causes 1, gastroesophageal reflux disease: due to the dysfunction of the lower esophageal sphincter, the lower esophageal sphincter relaxation, so that the gastric acid reflux, resulting in choking awake at night with acid reflux, can take proton pump inhibitors to reduce the secretion of gastric acid, such as omeprazole, pantoprazole, lansoprazole, etc., can also take drugs such as magnesium aluminum carbonate to neutralize gastric acid and relieve the symptoms; 2, cardia loss of flaccidity: due to the esophagus and lower cardia Sphincter pressure is elevated, it is difficult for food or liquid retained in the esophagus to enter the stomach, clinically some patients show food reflux after choking, acid reflux, etc. Patients often have a choking sensation when eating, barium meal, chest CT, gastroscopy and esophageal manometry can be further clarified, treatment can be performed balloon dilatation and endoscopic esophageal sphincterotomy to relieve; 3, duodenal disease: such as duodenitis, duodenal ulcer can cause excessive secretion of gastric acid, nighttime reflux, stimulation of the throat and choking, you can take pro-intestinal peristaltic drugs, such as domperidone tablets, aluminum magnesium carbonate, etc., you can also use the proton pump inhibitor omeprazole, rabeprazole, etc.