A healthy, pleasant and comfortable quality of life has become the fashionable pursuit of people. However, how many people have experienced heartburn and acid reflux after meals and even during non-meal times; how many people have had coughs and coughs (including the so-called “morning wetness”) of varying severity and even severe asthma-like attacks after meals, during meals, during sleep or in the morning (some patients were actually hospitalized several times and treated as (some patients were hospitalized several times and treated as “bronchial asthma” for a long time without any effect); how many people were troubled by different degrees of foreign body sensation in the throat for a long time, and even woke up at night due to poor breathing or involuntary (or irritating) coughing and sputum (for this reason, they could not sleep peacefully for years), and were inexplicably forced to live in a sitting or upright position; and how many people were forced to live in an upright position due to There are many people who are frightened by pneumonia, breathing difficulties and even asphyxiation caused by the ejection or misaspiration of reflux. All these phenomena often come from a familiar and unfamiliar disease that we seem to know but lack of understanding – Gastroesophageal reflexdisease (GERD), which is a condition caused by the reflux of stomach and duodenal contents into the esophagus, which can lead to GERD is a condition caused by the reflux of stomach and duodenal contents into the esophagus. In the Western population, about 7-15% of the population has gastroesophageal reflux symptoms 医学教育网收集整理. About 19 million adults in the United States have gastroesophageal reflux disease, most of which require medical treatment. Among them, 70,000 people receive various surgical treatments for this disease each year, and the annual cost of treating GERD in the United States amounts to $190 billion. The incidence of this disease increases with age, with the peak age of onset being 40-60 years old. At present, it is believed that the incidence of this disease in China is significantly lower than that in foreign countries. The reason for this is probably related to the lack of awareness and attention to this disease in the medical community, or the fact that only heartburn and reflux are noticed, without realizing that a considerable number of patients show cough, coughing, shortness of breath and even “asthma”, “coronary heart disease The cough, cough, shortness of breath, and even “asthma” and “coronary heart disease” that a large number of patients exhibit are caused by this disease. However, it should be especially mentioned here that domestic Pan Guozong has reported the epidemiological survey study about GERD in Beijing and Shanghai in 1999, which showed that the prevalence of GERD symptoms was 8.97%, the prevalence of GERD confirmed by endoscopy or 24-hour pH monitoring was 5.77%, and the prevalence of reflux esophagitis confirmed by endoscopy was 1.92%. GERD patients have discomfort such as heartburn and panacidity, and the symptoms can be long lasting, thus seriously affecting the quality of life and work of the patient. When patients develop extra-esophageal manifestations, especially respiratory complications, such as asthma-like attacks (but not asthma, and often poorly treated as asthma), the patient’s life can be endangered. When these patients are to undergo surgery, their prominent symptoms can make it difficult for the patient to undergo the procedure, especially if the GERD patient is combined with severe respiratory complications. Furthermore, during general anesthesia, due to the long period of lying down, a lot of regurgitant may accumulate in the pharynx of GERD patients, which may be dangerous when the tracheal intubation is removed just due to the residual or accidental aspiration of the regurgitant, or pneumonia may occur after the surgery. However, if the disease can be recognized before surgery and the patient is given neutron pump inhibitors for 2-4 weeks before surgery, the effect is very good although it is a simple task; if the disease is known in advance during anesthesia, special attention is paid and appropriate treatment is given, the safety of surgery can obviously be improved. In addition, the so-called Barrett’s esophagus caused by this disease is a precancerous state and should be given full attention. As long as the patient is correctly diagnosed, lifestyle modification and proper medical treatment can often lead to a better outcome. In case of poor results or when the patient cannot adhere to long-term medication, surgical or laparoscopic treatment can also be given. The author would like to give a brief introduction to the clinical manifestations of GERD, which seems to be well understood but in fact is still often ignored, especially the extraesophageal manifestations which are still unknown in China, as well as the new advances in the treatment of this disease, in order to draw people’s full attention. Medical diagnosis GERD is unique in that the regurgitant can reach the pharynx and form fine particles or mist, which can be sprayed into the larynx and inhaled into the trachea, bronchi and lungs, causing severe cough, sputum and dyspnea. The dyspepsia syndrome caused by GERD is self-explanatory. Therefore, in addition to heartburn and acid reflux, which are typical symptoms of GERD, it is important to look for atypical manifestations of GERD, such as chronic cough, hoarseness, foreign body sensation in the pharynx, snoring, nocturnal choking and/or episodes of dyspnea and asthma-like episodes induced by inappropriate eating. Precise diagnostic methods include esophageal dynamometry, which can clarify whether the lower (and also the upper) esophageal sphincter is relaxed and whether esophageal peristaltic function is low; 24-hour continuous esophageal acidity monitoring, which can clarify the number of refluxes in the upright and supine positions (number of pH <4), the maximum reflux time and exactly when this reflux occurs (at a certain time of the night) and the score (normal below 22, high above 80); and gastric acidity monitoring. Gastroscopy can clarify the presence and severity of esophagitis and exclude (or detect) lesions such as gastric tumors, ulcers, and diaphragmatic hernias; multichannel intraluminal impedance (mii) testing combined with esophageal acidity measurement can detect a more difficult to diagnose and treat non-acidic esophageal reflux. < p=""> The goal of treating GERD is to control the patient’s symptoms, cure the esophagitis, reduce recurrence, and prevent a host of serious complications. To reduce reflux that occurs at night and in the recumbent position, it is advisable to be in a sloped position (high pillows are not enough) or to elevate the head of the bed appropriately; to eat small, frequent meals and to avoid lying in bed immediately after meals, but only for at least 2 hours; to reduce factors that cause increased abdominal pressure, such as avoiding tight belts, avoiding constipation and controlling weight; to avoid high-fat foods, chocolate, coffee, strong tea, and to abstain from smoking and alcohol. Drug treatment for GERD includes gastrointestinal motility drugs (such as morpholine), gastric mucosal protective agents, H2 receptor antagonists (such as cimetidine, etc.) and neutron pump inhibitors (Protonpumpinhibitor, PPI, such as Nexium, omeprazole, lansoprazole, etc.). These drugs are quite effective in relieving symptoms. In case of respiratory complications, appropriate treatment must be available, such as proper inhalation of sulforaphane and appropriate application of antimicrobials. Although medication is effective in treating GERD, the relapse rate after stopping medication can be very high, so long-term treatment is inevitable. In this way, patients not only suffer from certain complications caused by the drugs (such as indigestion or bloating due to decreased gastric acid, or worse, decreased white blood cells), but also cause many inconveniences to their lives. In addition, antacids are not effective in patients with non-acidic esophageal reflux. In addition, when the sphincter of the lower esophagus (especially with the upper end) is relaxed, the reflux can be sprayed straight to the larynx, which is obviously a mechanical lesion. At present, it has been commonly found in Europe and the United States that in patients with asthma-like attacks GERD is very common and its incidence is increasing. The fact that many patients with asthma or asthma-like attacks experience a significant reduction or disappearance of symptoms after the administration of anti-reflux medication or surgery further demonstrates the close relationship between GERD and respiratory tract pathology. In other words, there should be a group of patients in whom anti-reflux treatment by medication or surgery can both control serious respiratory pathology and cure or relieve GERD. The strong gastric acid is essential for digesting food, and only the gastric mucosa has the unique anti-acid function; while the esophageal mucosa cannot withstand the stimulation of gastric acid, and acid reflux can immediately cause heartburn; as for the larynx, trachea, bronchus and other respiratory mucosa, they are resistant to gastric acid. The mucosa of the respiratory tract is even less resistant to gastric acid. Once exposed to gastric acid, it immediately causes strong contraction of the smooth muscles of the respiratory tract (dyspnea) and a large amount of mucous membrane secretion (phlegm) and severe coughing (expectoration), which is the cause of asthma-like attacks. Have you ever observed a patient with an asthma-like attack, a persistent cough, during or after a meal or during sleep at night, who has been treated for asthma but has not significantly improved their symptoms and is in the process of seeking further medical attention? If so, he is reminded that he is probably suffering from a serious (and fatal) respiratory complication of GERD. To date, this is still far from being taken seriously enough in the country. Therefore, it is really necessary to strengthen the in-depth investigation, active research and extensive publicity of this disease, in order to raise awareness of the disease, so that GERD patients can get correct diagnosis and timely and effective treatment as early as possible.