GERD (gastro-esophageal reflux disease) is the collective name for pathological gastroesophageal reflux and its complications, and is a common gastrointestinal disease that has received widespread attention in recent years. The peak age of onset is between 60 and 70 years old. If this is projected, at least 70-80 million people in China will be affected by this disease. GERD and its comorbidities have a variety of symptoms and clinical manifestations, including esophageal symptoms and extraesophageal manifestations, the main symptoms are as follows: 1, heartburn: heartburn is the most common symptom of gastroesophageal reflux disease, as a result of chemical stimulation of the subepithelial sensory nerve endings of the esophagus by acidic reflux, manifested as a warm or burning sensation in the upper abdomen or behind the sternum, typically occurring more than 1 to 2 hours after eating Heartburn can be triggered by certain irritating foods. Nearly 50% of adults in the United States complain of heartburn at least once a month, and more than a quarter of adults take antacids at least three times a month. This shows that the incidence of GERD is likely to be higher than we currently know. 2. Regurgitation: Regurgitation is the overflow of stomach contents upward into the oropharynx without nausea, dry heaving, abdominal contractions, or exertion by the patient. Regurgitation during fasting is acidic gastric juice reflux called acid reflux. Regurgitation or acid reflux is one of the common symptoms of GERD, which occurs in about 40% of GERD patients. 3. Difficulty in swallowing: Difficulty in swallowing is also a common symptom of GERD. In the early stage, it is caused by esophageal spasm due to inflammatory irritation, and in the late stage, it can appear as continuous dysphagia due to lower esophageal stricture. The incidence of dysphagia in GERD patients is about 30%. 4. Chest pain: Chest pain also has a high incidence in GERD. More than 60% of all patients with non-cardiogenic chest pain are associated with GERD. 5, chronic cough: chronic cough refers to cough symptoms lasting for more than 3 weeks, the effect of conventional examination and treatment is not good and the cause is unknown. gerd is one of the most common causes of chronic cough, accounting for 10-20% of the causes of chronic cough, of which cough as the only clinical symptom of GERD accounts for about 40%. 6, throat symptoms: GERD can cause a variety of throat symptoms, mainly including: foreign body sensation in the throat, dysphonia, pain in the throat, burning sensation in the cheek, chronic hoarseness, etc. Many patients seek medical consultation with this as the main complaint. 7, other symptoms: GERD can also have some other clinical manifestations such as: gastrointestinal distension, belching, excessive salivation, intermittent fecal occult blood, etc. It is worth noting that fecal occult blood in children may be the only manifestation of GERD. GERD has a mild initial manifestation, but it can cause multi-system damage through a series of pathological changes and cause a variety of other diseases, which can be said to be a source disease, mainly including: 1. Respiratory diseases: GERD can cause a variety of respiratory diseases, mainly including: bronchial asthma, pulmonary atelectasis, aspiration pneumonia, lung abscess, bronchiectasis, chronic bronchitis and pulmonary fibrosis etc. 2, digestive system diseases: GERD can cause reflux esophagitis, Barrett’s esophagus, esophageal adenocarcinoma and other digestive system diseases. Gastroesophageal reflux causes mucosal breakage of the esophagus called reflux esophagitis RE. Endoscopic diagnosis and grading of reflux esophagitis has been developed in China: grade 0 normal (may have histological changes); grade 1 dotted or striped redness and erosion without fusion; grade 2 dotted or striped redness and erosion with fusion, but not circumferential; grade 3 extensive lesions with redness and erosion circumferential, or ulceration. The basic pathological changes of GERD are: esophageal squamous epithelial hyperplasia, extension of the papillae of the lamina propria to the surface, infiltration of neutrophils and lymphocytes in the epithelium, mucosal erosion or ulceration forming granulation tissue formation and/or fibrosis, and Barrett’s esophagus. It is clear that GERD can lead to esophageal ulceration, stricture, short esophagus and Barrett’s esophagus. The relationship between GERD and Barrett’s esophagus and esophageal adenocarcinoma has received the most attention, as Barrett’s esophagus is considered to be the result of long-term chronic gastroesophageal reflux and a precancerous lesion for esophageal adenocarcinoma. The chance of esophageal adenocarcinoma is 30 to 125 times higher in normal people. Gastro-heart syndrome: Gastro-heart syndrome, also known as Roemheld syndrome, was first reported by Roemheld in 1912, which is a series of digestive symptoms and anterior heart pain caused by esophageal or cardia spasm, gastric mucosal prolapse, and perforation of the posterior gastric wall. GERD can cause such symptoms, which may be due to the aggravation of coronary spasm through neurological reflexes based on the original coronary artery disease. 4, ENT diseases: GERD can cause a variety of ENT diseases, such as: chronic sinusitis, chronic otitis media, vasodilatory rhinitis, laryngitis, contact ulcers or granulomas in the larynx, vocal cord nodules, subglottic stenosis, pharyngitis, squamous carcinoma of the pharynx, etc. 5.Corrosive dental injury: GERD, especially GERD without obvious symptoms, can be caused by long-term acid reflux corrosion of teeth, and the symptoms associated with it are oral burning sensation, tooth hypersensitivity, poor bite, proprioceptive disorders, etc. Schroeder et al. have reported that 11 out of 20 GERD patients were complicated by corrosive dental injury. 6, sleep apnea syndrome: Many foreign scholars have confirmed that there is a strong correlation between sleep apnea syndrome and GERD, but the real relationship between the two see whether they are causal or just have the same susceptibility factors, is still unclear and requires further research. Kirk reported that 77% of female patients with GERD had disturbing heartburn symptoms during intercourse, but most of them were relieved after appropriate treatment. In conclusion, GERD has a high incidence and may cause a variety of other diseases. It is a source disease that causes serious damage to patients’ health and even threatens their lives, and it should be taken seriously and patients should be accurately diagnosed and treated appropriately. However, at present, not only patients do not understand and pay attention to GERD, but also many doctors do not know enough about it, so many GERD patients do not get good diagnosis and treatment and lose the best time for treatment. Thoracic surgeons should pay more attention to GERD and conduct more in-depth understanding and research on it in order to relieve patients’ pain to the maximum extent.