Gastroesophageal reflux is a manifestation of gastrointestinal disorders. This phenomenon becomes reflux asthma due to the irritation of acidic gastric juice, which can lead to diseases such as esophagitis and upper respiratory tract inflammation. When gastric juice is inhaled into the airway it can cause an asthma attack. In asthmatic patients, the incidence of gastroesophageal reflux symptoms is 45% to 60%; asthmatic patients present with nausea, acidity, and burning pain in the upper abdomen. Pathophysiology: It is believed that the mechanism of GERD-induced asthma may be mainly due to the reduced tone of the lower esophageal sphincter. 1. Gastric fluid components stimulate the afferent nerve of the esophageal vagus nerve, which is transmitted via the vagus nerve of the airway, resulting in bronchospasm. This idea is illustrated by the fact that inhalation of anticholinergic agents in early asthma has a better response than inhalation of sympathomimetic drugs. 2, Gastric reflux into the airway can cause bronchospasm, which is due to the stimulation of acidic components in gastric juice, causing an increase in airway resistance. In the excitation test, if the acidic liquid flows into the airway, then the bronchospasm effect will increase more than 2 times. Bronchospasm symptoms can be improved after the application of antacid drugs. 3. Gastric reflux increases bronchial reactivity and enhances the sensitivity of asthmatics to various triggers. Diagnosis: A sudden onset of nocturnal cough, wheezing, chest tightness, wheezing accompanied by nausea, acid reflux, burning pain in the upper abdomen, especially aggravated by position change, or aggravated by the application of theophylline therapy, is a preliminary diagnosis of asthma with gastroesophageal reflux, and a few obese patients with reflux due to increased abdominal fat, abdominal distension, and increased intragastric pressure need to be excluded. For patients suspected of aspiration of gastric fluid, 24-hour measurement of esophagogastric pH by dual channels is feasible to confirm the diagnosis. Diet and lifestyle habits are important for GERD. Avoid stimulating foods such as acidic and spicy foods; appropriate weight loss should be considered for obese patients. Raising the pillow position during sleep may also be an effective method. Medication (1) H2 antagonist: the dose should be sufficient, recommended to use ranitidine 300mg, or famotidine 40mg, or cimetidine 600-800mg, 1h before breakfast and dinner, but not used together with antacids. (2) Antacids: antacids, bismuth aluminate (gastric bismuth) can inhibit and neutralize gastric acid, reduce and lower the H concentration in gastric juice, and effectively relieve reflux symptoms. (3) Dopamine blockers: such as metoclopramide, domperidone, etc. These drugs can accelerate gastric emptying and have a certain effect on the lower esophageal sphincter. (4) proton pump inhibitors: antacid plus H2 antagonist treatment can not control reflux, can use proton pump inhibitors such as omeprazole (omeprazol) (5) mucosal protective agents: magnesium aluminum carbonate tablets, aluminum magnesium plus suspension, aluminum phosphate gel can be used to protect the gastric mucosa, but magnesium aluminum carbonate tablets have the effect of treating bile reflux, aluminum phosphate gel has the side effect of constipation, constipated patients Should not be used. For a small number of people with GERD due to obesity, weight loss should be considered. If symptoms persist despite the above treatment, the patient should be re-evaluated, examined, and endoscopy should be performed, especially for those patients with wasting and anemia, further examination and diagnosis should be noted. If gastroesophageal reflux is not easily controlled and there is too much acid in the stomach, anti-reflux surgical treatment needs to be considered. Some surgical experts believe that careful and appropriate selection of patients for surgical treatment will result in long-term control of heartburn and reflux symptoms in 90% and long-term control and improvement of respiratory symptoms, especially cough, in 75%. Prognosis Subjective factors affecting the prognosis of asthma, the age of the patient is one of the very important judgment indicators, usually, the prognosis of childhood asthma and adolescent asthma is better, while the prognosis of elderly asthma is worse. Prevention 1. A few people with gastroesophageal reflux due to obesity should lose weight as appropriate. 2. Avoid foods that produce too much stomach acid in the diet. 3. Anti-reflux surgery should be considered when necessary.