Gastroesophageal reflux disease (GERD) is a clinical syndrome characterized by heartburn and acid reflux caused by the reflux of gastroduodenal contents into the esophagus. According to the endoscopic findings, there are two types of GERD: non-erosive GERD (NERD), which is called “pathological reflux”, and reflux esophagitis (RE), which is called “pathological reflux”, if there are obvious inflammatory lesions such as erosions and ulcers. “The clinical term “gastroesophageal reflux disease” mostly refers to NERD. In the past, it was thought that NERD was a milder form of RE, and that GERD progressed from NERD to RE, and then to Barrett’s esophagus (BE) and esophageal adenocarcinoma. Recent studies tend to consider NERD, RE and BE as three separate diseases, each with its own separate pathogenesis and complications, almost independent of each other. There is no evidence to support the progressive development of NERD to RE, nor can it be proven that BE evolves from RE or NERD. The incidence of GERD is very high in western countries, with a population prevalence of 10%-30%. In the past, GERD was rare in China, but the incidence has gradually increased in the last 10 years or so. 1, what is the pathogenesis of gastroesophageal reflux disease NERD occurs as a result of a decline in the anti-reflux defense mechanism of the esophageal cardia and the enhancement of the attack of reflux on the esophageal mucosa, under normal circumstances, the lower esophageal sphincter (LES) pressure exceeds the high-pressure band of gastric pressure, which prevents the reflux of gastric contents into the esophagus, when the LES pressure decreases, the intra-abdominal pressure increases the septal pressure difference can induce the occurrence of the disease, of which, the transient LES relaxation (TLESR) plays an important role in the pathogenesis. 2, diagnostic treatment test Proton pump inhibitors (PPI) have a powerful and rapid acid suppressing effect, the main drugs in this category are Nexium, Polite, Omeprazole, etc., the patient can take the symptoms can be rapidly relieved, and therefore can be used as a diagnostic tool for patients with GERD, patients suspected of GERD can be given Esomeprazole 40mg, qd or 20mg, 2 times / d, oral 7d, the symptoms can be significantly relieved Confirmation of the diagnosis. Suspected reflux-related extra-digestive symptoms, such as foreign body sensation in the throat, hoarseness, chronic cough, asthma or non-cardiac chest pain, should be treated experimentally for at least 12 weeks, and symptom relief will confirm the diagnosis. If the patient has alarm symptoms such as dysphagia, wasting, malignancy, bleeding, etc., this test should not be used to avoid delaying the disease. 3, the treatment strategy of GERD is mainly to reduce the symptoms, promote the recovery of mucosal inflammation, treat complications and prevent recurrence? Since acid reflux is the main etiology, acid suppressants are currently the most important therapeutic drugs. If patients are ineffective to conventional treatment with acid suppressants, the correct diagnosis, the presence of alkaline reflux or the presence of complications such as stenosis in patients should be analyzed, and the factors affecting the drugs, such as patient compliance, differences in biological activity produced by oral PPI in different individuals, and the effect of hepatic pharmacological enzyme P450 on PPI metabolism, should be noted. Since the disease involves long-term treatment, comprehensive and individualized treatment plans should be considered in the treatment, such as increasing the dose of PPI, switching to enzyme preparations that do not affect cytochrome P450 drugs, adding H2RA or power drug surgery, etc. GERD is a chronic recurrent disease, some patients may develop in infancy and require lifelong treatment, most patients have symptomatic relief after 4-8 weeks of initial treatment, but more Most patients have relapse within six months, and the disease relapse rate is about 57%-90%, therefore, it is especially important to maintain treatment to prevent relapse. There are two types of maintenance regimens: continuous and discontinuous, the former being a regular dose of acid suppressant given orally as one tablet daily for more than six months after reflux symptoms have been controlled. Discontinuous therapy can be given intermittently or on demand? Intermittent dosing refers to short-term dosing at certain intervals, usually 1-2 weeks. On-demand treatment is determined by the patient and there is no fixed course of treatment, dosing when symptoms appear and stopping after symptoms are controlled. 4.About eating habits and sleep patterns Lifestyle changes are important treatments for GERD, including small and frequent meals, avoiding overfilling, standing and walking appropriately after meals, and not eating before bedtime. Avoid gas or acidic drinks and stimulating foods, less desserts and low-fat diet can reduce abdominal distension; obese patients can lose weight appropriately to reduce abdominal pressure, elevate the head of the bed 15-20cm or pad the shoulders during sleep, and make patients have a correct understanding of the disease to avoid increasing psychological burden and pursuing inappropriate treatment measures.