Everyone has experienced acidic gastric reflux. It is just that the vast majority of people fall into the category of occasional occurrences. It is only considered reflux esophagitis if it occurs frequently and even causes uncomfortable symptoms and inflammatory changes in the esophagus. The most typical manifestations of reflux esophagitis are heartburn, gastroesophageal reflux and difficulty swallowing. Modern life is not easy. With the increased pressure of life and westernized eating habits, the incidence of reflux esophagitis is gradually increasing, with an increasing number of young people developing the disease. When the disease is serious, patients will have obvious heartburn reflux, even can not lie down, seriously affect the night sleep; or eating difficulties, wasting, resulting in malnutrition; some patients will also be accompanied by obvious anxiety and even depression, thus seriously affecting the quality of life of patients. Drugs – the preferred treatment for reflux esophagitis “Stomach, how are you?”, “Indigestion, get *** help” – -More and more drug commercials landed on TV screens, the people’s medication habits submerged. But are you taking the right medicine? In the case of reflux esophagitis, medication is mainly administered by gastroenterology after diagnosis. The drugs used include those that inhibit acid secretion (Oxy, Rabeprazole, Lansoprazole, Esoprazole, etc.), those that protect the gastric mucosa (Daxil, Thioglycollate, etc.), and those that promote gastric emptying (Morpholine, Cisapride, etc.). In addition, it is combined with diet modification. With this treatment, most patients can get a good treatment effect. However, there are still a considerable number of people with poor treatment results, mainly manifested as follows: 1. The symptoms of heartburn and acid reflux are relieved, but the patient is still unable to lie down, and the symptoms of gastric contents reflux are not relieved; 2. The symptoms of heartburn and reflux have been relieved for a period of time, but the efficacy of the drugs is getting worse; 3. The symptoms of chest pain, hiccups and bad breath are not relieved; 4. The symptoms recur and appear immediately after stopping the drugs, or because The toxic side effects of the drugs appear after long-term medication and forced to stop medication. These conditions make patients suffer physically and mentally. What should I do if medication does not work? Internal medicine treatment for reflux esophagitis is “treating the symptoms but not the root cause”. This is closely related to the causes of the disease and the changes in the physiological structure. First, the anti-reflux barrier is “pushed down”. After the disease, the lower esophageal sphincter is weak, that is, the anti-reflux barrier function is reduced; lower esophageal peristaltic function is reduced, the function of clearing reflux; gastric emptying dysfunction, so that the gastric cavity pressure to promote reflux. It is evident that the presence or absence of an anti-reflux barrier is critical to the treatment of the disease. All drug treatments are used to reduce gastric acid secretion and lower acidity, but do not help to restore the reflux barrier. In other words, after drug treatment, reflux is still present, but it is just less acidic and somewhat less irritating to the esophagus. Second, a hiatal hernia and severe dysfunction of the lower esophageal sphincter. Esophageal hiatal hernia is a common cause of reflux esophagitis. As the hole where the esophagus passes through the diaphragm (esophageal hiatus) becomes significantly enlarged, the esophagus moves up into the chest, severely weakening the valve function of the esophageal sphincter and failing to control the reverse movement of gastric acid. Over time, the esophageal hiatal hernia will become larger and the shortening of the esophagus will increase, further aggravating the reflux symptoms. The lower esophageal sphincter is a direct anti-reflux barrier, like a one-way valve between the stomach and esophagus, and once it is broken, drugs cannot fundamentally solve the reflux problem. Foreign data show that hiatal hernia and lower esophageal sphincter disruption are “one and the same”, and the two often coexist and are closely related to severe reflux symptoms, Barrett’s esophagus and cancer. Countermeasure: Barium meal + esophageal manometry. The former can clearly see if there is a hiatal hernia. The latter allows a complete assessment of the function of the lower esophageal sphincter. Once diagnosed, the only way to cure it is through surgery, and the earlier the surgery, the better the results. Modern advances in material science, especially the application of various patches, have made laparoscopic esophageal hiatal hernia repair surgery a safe and effective treatment for hiatal hernia-reflux esophagitis. Third, abnormal gastric motility. Abnormal gastric emptying function is the third etiology of reflux esophagitis. We have found during surgery that many patients have gastric prolapse and decreased gastric tone, and many patients also often have indigestion, gastric distention, and indigestible food before surgery. Countermeasure: Surgery is like wrapping a scarf around the stomach to restore the anti-reflux barrier, which is a “blocking” strategy; then, through the traditional Chinese medicine of our country, we can lower the pressure of the gastric cavity and restore the power of the gastrointestinal tract, which is a “unblocking” strategy. “Then, through the traditional Chinese medicine, we can reduce the pressure of the gastric cavity and restore the power of the gastrointestinal tract. The combination of surgery and Chinese medicine is the strategy of “blocking” and “unblocking”, which fundamentally solves the cause of reflux esophagitis. Fourth, too much mental stress. A growing number of studies have shown that patients with reflux esophagitis are significantly more likely to experience depression and anxiety than other diseases. There are significant abnormalities in the mental state of patients due to prolonged recurrent episodes of acid reflux, nutritional disorders, and sleep disorders. This abnormal psychological and mental state can in turn affect and weaken the gastrointestinal motility function, exacerbating the symptoms and forming a vicious cycle. Countermeasures: Foreign studies also suggest that surgery and medical treatment followed by psychotherapy will achieve better results. Our experience is that patients with reflux esophagitis are given psychological assessment and counseling, and psychological intervention if necessary. This helps to relax and improve the patient’s response to other treatments. Some patients who developed significant gastrointestinal dysfunction after surgery, vomiting and inability to swallow, were treated with psychotropic medications and all symptoms were relieved. Fifth, reflux esophagitis is “atypical”. Some patients are plagued by angina pectoris, chest pain, recurrent pneumonia, asthma, or persistent laryngitis, sleep disorders, and have been seen in multiple departments such as cardiology, respiratory medicine, quintuplegia, and neurology, but have not received effective treatment. After going round and round, it was finally discovered that the culprit was reflux esophagitis of the digestive system. Countermeasure: Reflux esophagitis is a “lady with a thousand faces” with many different manifestations. If you have symptoms such as angina, chest pain, recurrent pneumonia and asthma, persistent laryngitis, sleep disorders, etc., and you have not seen any results even after years of treatment, you can use the exclusion method and go to the gastroenterology department to check if it is acid reflux. It is also recommended that those with these symptoms seek help at a specialized reflux esophagitis treatment center or at a hospital with multidisciplinary collaborative care for reflux esophagitis. Finally, we would like to reassure patients that the majority of patients with reflux esophagitis will have a good outcome with medication. However, there is more than just medication for reflux esophagitis. It is important not to lose confidence if there is a poor outcome, but to find the cause of the poor outcome. The combination of Chinese and Western medicine – both medical and surgical treatment – and physiological and psychological assistance has become the ideal treatment model for reflux esophagitis, and its efficacy is increasingly recognized.