Gastroesophageal reflux disease (GERD) is not only a disease of the stomach and esophagus, but its extra-digestive manifestations, especially respiratory complications, such as chronic cough, chronic pharyngitis, bronchial asthma, and aspiration pneumonia, are receiving increasing attention. Gastroesophageal reflux cough (GERC), about half of which manifests clinically as chronic cough alone without typical GERD reflux-like symptoms, is non-specific compared to other causes of chronic cough, and its diagnosis and treatment are difficult. The pathogenic mechanisms include: direct irritation of the regurgitant, airway microaspiration, and vagal reflexes. 1. local stimulation: in the absence of aspiration, cough is caused by stimulating the afferent cough reflex by stimulating the local mucosal stimulation of the pharynx; 2. inhalation stimulation: the inhalation of refluxed material stimulates the lower airways and causes cough (micro aspiration can lead to pharyngitis and bronchitis; mass aspiration can cause pulmonary aspiration syndrome, erstwhile pneumonia, pulmonary fibrosis, bronchiectasis, etc.); 3. nerve reflex: stimulation of Esophageal-bronchial cough reflex causes chronic cough. Acidic digestive juices in the stomach flow back into the lower esophagus, stimulating the vagus nerve of the respiratory tract and causing smooth muscle spasm to occur shortness of breath. Auxiliary examinations: including barium meal examination, gastroscopy, esophageal manometry, 24-hour pH monitoring of the esophagus, etc. 1.Barium meal examination: upper gastrointestinal tract imaging (barium meal examination) is one of the easy methods to diagnose gastroesophageal reflux, and if barium is observed to move from the stomach to the esophagus, gastroesophageal reflux can be detected. However, the specificity and sensitivity of barium meal examination are poor. 2, gastroscopy: electronic gastroscopy is the most direct evidence to find pathological changes in the esophageal mucosa and prove the presence of gastroesophageal reflux related erosive esophagitis. About 60% of patients with symptoms such as retrosternal burning sensation and acid reflux are found to have esophageal mucosal damage during gastroscopy. However, not all gastroesophageal reflux can lead to chronic cough; 3. Esophageal manometry: transient sphincter relaxation in the lower esophagus is an important cause of reflux; 4. 24-hour esophageal pH monitoring: 24-hour continuous monitoring of esophageal pH in patients under physiological conditions with the application of a pH recorder can provide objective evidence of the presence of excessive acid reflux in the esophagus, and 24-hour esophageal pH monitoring is currently considered is currently considered to be one of the most important and sensitive diagnostic measures. By dynamically monitoring the change of esophageal pH, six parameters such as the number of times of 24-hour esophageal pH <4, the longest reflux time, and the percentage of esophageal ph>4 in the monitoring time are obtained, and finally the degree of reflux is expressed by Demeester’s score, and the reflux-related symptoms are recorded in real time during the examination to obtain the probability of correlation between reflux and cough symptoms and to clarify the relationship between reflux temporal phase and cough. Prevention 1. Avoid overeating and binge eating Develop regular eating habits and do not be hungry or full. Overeating can lead to expansion of the gastric fundus, reflexively causing relaxation of the lower esophageal sphincter and triggering acid reflux. So patients should eat less, more meals, three meals to 70% full is appropriate, such as hunger can add a small amount of snacks between meals, it is best not to eat before bed. 2, avoid irritating food irritating food if reflux to the esophagus can directly act on the inflammatory site, aggravating the heartburn. On the other hand, there are many irritating foods, such as coffee, chocolate, alcohol, mint, etc. can reduce the tension of the lower esophageal sphincter, slowing gastric emptying. Fat, nicotine, nitroglycerin, etc. can also cause relaxation of the lower esophageal sphincter. Therefore, “heartburn” should quit smoking, quit drinking, keep the diet light, eat more vitamin-rich vegetables, fruits and protein-rich fish, shrimp, poultry, eggs, etc. 3, avoid lying down immediately after meals, the gastric fundus expansion, can reflexively cause the lower esophageal sphincter relaxation, in order to digest food, the stomach secretes a lot of gastric acid, the most likely to occur acid reflux. If you lie down at this time, it is bound to cause a large amount of gastric acid reflux into the esophagus, which aggravates the esophageal damage. It is best to be able to 3 hours after the meal, to wait for most of the food by the stomach emptying before going to bed, sleep should try to keep the head high foot low position (to 30 º appropriate). 4, control obesity obesity not only increases the burden on the heart, but also can make the tension of the lower esophageal sphincter reduced, increasing the chance of acid reflux. Obese people should actively control weight, avoid intake of high-fat diet, eat more vegetables and fruits, actively participate in outdoor activities, and appropriate physical exercise. 5, maintain an optimistic attitude, avoid emotional tension Statistics found that the incidence of heartburn is much higher in urban residents than in rural residents. With the accelerated pace of people’s life and the increase of mental stress, long-term mental tension can affect the function of the lower esophageal sphincter and induce acid reflux, so patients should often maintain an optimistic mood.