Patient: This onset was in early August and the main symptoms were cough, regurgitation, breath-holding, foreign body sensation in the pharynx, belching Laboratory tests, acid measurement, pressure measurement, gastroscopy Regurgitant cough symptoms in January 08, improved by taking western medicine for more than a week Expect to be cured and not to recur Hospital GERD Center: Based on your examination results and treatment, I currently consider your cough to be related to GERD. The current methods of treatment for GERD include: general lifestyle improvement, medication, gastroscopic treatment and surgical fundoplication, etc. After control and intervention by the above methods, most patients can get significant relief and control. However, I also have to tell you with regret and reluctance that GERD is a chronic recurrent disease, and there is no method at home or abroad that can achieve the efficacy of completely curing the disease – making it not recurring. So I hope you can look at the disease rationally and change the idea of “once and for all”, and I also believe that your annoying cough can be controlled through good lifestyle management and reasonable medication. However, in view of your special circumstances, intensive medication can be given in the short term (usually 2-3 months). For example: take Chinese herbal medicine along with western medicine such as Nexium, Daxil and Gastrointestinal Dynamics to control the cough symptoms as soon as possible, and then try to stop the medicine or see the minimum amount of medicine as soon as possible. I don’t know if you are satisfied with this reply? Patient: Doctor, thank you for your reply. I’ve stopped coughing a week before the holiday, including during the trip because it was inconvenient to take the Chinese medicine with me. Now I only have occasional hiccups and belching every day, and my food reflux is rare. I feel that perhaps I have passed this time. I will follow your reminders and slowly change my bad habits. I really don’t want to take any more medication, and I feel exhausted from always running to the hospital. Thank you once again for your patient and detailed consultation and response. I wish you good mood! Hospital GERD Center: I am very happy to hear that your symptoms have basically disappeared so far, and I hope to continue to adhere to a good lifestyle. Hello, Dr. Wang, I was happy when I replied online on the 5th that I no longer had a cough, and my food return and belching were rare. However, in the past two days, I have been feeling uncomfortable again, and I have started to return to eating after meals, and the sensation of a foreign body in my throat after meals is very uncomfortable. In particular, the number of burping and belching has increased again in the past two days, and I have started taking Chinese medicine again. I would like to ask if the foreign body sensation in the throat is due to pharyngitis. Can I get rid of it by taking medicine for pharyngitis? I’ve been taking Chinese medicine without deciding to take Western medicine, not because I don’t believe in Western medicine, but for the past 2 years I’ve been seeing Chinese and Western medicine over and over again, switching between Chinese and Western medicine, and this time I want to stick with Chinese medicine for a while longer. You are so patient with your patients, and you make people feel close to you, so maybe I should not consult with you, but I have to trouble you to consult with you, I am really sorry. I know you are busy at work and there is no hurry to reply, anyway this symptom has been long enough, don’t care about a few more days. Thank you again! Hospital GERD Center: Hi, frankly speaking, reflux, erratic reflux (burping), belching and foreign body sensation in the throat are expected to recur after stopping medication, as the disease is a chronic recurrent disease (see second post). It is more common to get better on medication (either Chinese or Western) and relapse after stopping it. Gastroesophageal reflux is an upper gastrointestinal tract dysfunctional disease, traditional Chinese medicine has certain advantages in this regard, and you take Chinese medicine is also effective, so you can continue to treat, but it is best to go to a regular Chinese hospital, do not trust private “Chinese medicine clinics or pharmacies of famous doctors”. Because pharyngitis is secondary to GERD, controlling the reflux is the root of the problem, and treating pharyngitis is the cure. The pharyngitis you have is, in my opinion, caused by gastroesophageal reflux, and the root is in the treatment of reflux, but laxative drugs can be used at your discretion. In my heart, I treat each patient as my own, and we are all living beings. I always have a respect for life, and when I listen to each patient’s story about the pain and helplessness they face, I feel the same way. As a general practitioner, I have the responsibility to do my best to save lives and protect them; every patient also has the right and should receive the most appropriate diagnosis and treatment. I wish you all the best! Patient: Depressioning Hospital GERD Center: Doctors and patients are close comrades, and disease is our common enemy. As doctors, we should do our best to improve our medical technology and provide the most appropriate treatment for our patients (the principle of “highest efficiency ratio” in economics, which causes the least mental, physical and economic damage to patients while maximizing the effect of treatment). On the other hand, the patient should also take the initiative and use all the resources around him/her to find ways to take palliative or control treatment measures within his/her ability to fight the disease. To paraphrase Mao’s words, “despise disease in strategy, and attach importance to it in battle”. Moreover, with the continuous progress and development of medicine, there will definitely be more effective methods for the diagnosis and treatment of the disease, and I believe that a cure will not be too far away! Please build up confidence Patient: Yesterday I went to the outpatient clinic of Kuanjie Chinese Hospital, the doctor prescribed 14 more Chinese medicines and added a western medicine to me called rabeprazole, saying that it treats acid reflux, I said I don’t have acid reflux, the doctor said that just because you don’t perceive acid reflux doesn’t mean you don’t have acid reflux. I want to consult with Dr. Wang, do I really have to take it? (I don’t want to take western medicine, and I still have a bunch of medications at home that I was prescribed in August at the Sino-Japanese Friendship Clinic that I didn’t take.) I see that my acid test report doesn’t say that I have acid reflux, and I don’t feel that way myself. Regarding the report of esophageal manometry, I didn’t understand whether there was any problem with this manometry when I consulted with you last time. Dr. Wang, could you please take the time to explain this to me? Thank you! Gastroesophageal reflux disease center: review your 24-hour esophageal PH monitoring: no acid reflux (excluding alkaline reflux), esophageal manometry results suggest: lower esophageal sphincter pressure 10.7 mmHg (lower than normal), low pressure in the middle and distal esophagus, no esophagitis manifestation in gastroscopy. Based on your clinical symptoms, effective anti-reflux results and the above three tests, you are currently considered to have non-erodible GERD (a type of GERD, also known as endoscopic negative GERD). The characteristics of non-erosive GERD are as follows: 1. there may be reflux (including regurgitation, acid reflux, regurgitation of bitter water, etc.), heartburn, chest and back pain and other esophageal manifestations, and or chronic cough, asthma, pharyngeal foreign body sensation and other symptoms; 2. there may be lower lower esophageal sphincter pressure (LESP) on esophageal manometry, and low LESP is the pathophysiological basis for the pathogenesis of GERD; 3. there is no congestion, edema, erosion, or rupture of the esophageal mucosa on gastroscopy. edema, erosion, and rupture of the esophageal mucosa; esophageal PH monitoring for acid reflux can be negative or positive. 4. Patients with this disease have increased sensitivity of the esophageal mucosa, and even a small amount of reflux (normal gastroscopy is difficult to detect esophageal mucosal erosion, and electronic gastroscopy reveals widening of the esophageal epithelial gap) can trigger symptoms in patients. Regarding the question of whether acid reflux is present or not, firstly, the patient’s conscious symptoms are not completely consistent with pathological acid reflux, and the clinical encounter with acid test results suggesting severe acid reflux, but the patient does not have any reflux symptoms, which may be the reason for your confusion; secondly, studies have shown that most GERD is mixed acid-base reflux (when the acid test can be “normal” due to acid-base neutralization “Therefore, clinicians routinely give acid suppression therapy to GERD patients, regardless of whether they have acid reflux symptoms or acid test results. In addition, rabeprazole is one of the acid-suppressing drugs, there are also omeprazole, lansoprazole, pantoprazole and esomeprazole in the domestic market, if you have the drug on hand either one can be chosen. Hope this helps!