Under normal circumstances, the pressure in the esophagus is greater than the internal pressure of the stomach, and at the junction of the esophagus and stomach there is a muscle called the sphincter muscle, which tightly ties the stomach as a pocket, so that the contents of the stomach rarely reflux into the esophagus. Once this muscle is loose, or the pressure in the stomach is too high, the contents of the stomach will flow back up. If the esophageal mucosa is constantly stimulated by stomach acid or bile, the esophageal mucosa will erode and form ulcers or even develop into esophageal cancer. In fact, most people have experienced GERD symptoms. Some people feel that “after eating a meal, a hot stream rises up from the stomach, and the heart feels as sad as fire”, and sometimes “acid and food from the stomach rushes directly into the mouth”, if this typical GERD symptom –If this typical GERD symptom – “heartburn, acid reflux, and regurgitation” – occurs frequently, then you may have GERD. However, because GERD can be tricky and fickle, some people still see the wrong department. There are often patients who feel “significant pain at the back of the sternum” and are diagnosed with GERD only after having a cardiogram, chest CT, ECG, etc. and taking a bunch of medications. And when it is due to acid reflux into the trachea, throat, or mouth, causing chronic cough, bronchial asthma, pharyngitis, burning sensation in the mouth, bad breath, or even tooth decay, it is even more difficult to seek accurate medical attention. This suggests that if you experience incurable chest pain and chronic inflammation of your respiratory tract, ear, nose and throat, you should be alert to the possibility that the root of the disease is GERD. Dangers of GERD Severe GERD is often accompanied by vomiting of coffee-like or bloody matter in the stomach, as well as fear of eating due to painful swallowing and obstruction during swallowing, which can cause chronic anemia in the long term. Also, due to long-term acid reflux, repeated irritation of the esophageal mucosa causes chronic inflammatory reactions, resulting in the formation of scar tissue in the esophageal mucosa, leading to esophageal stricture, and in severe cases, even esophageal perforation, which requires surgical treatment. How to treat GERD 1. General treatment: change the lifestyle, such as elevating the head of the bed by 15-20cm, quit smoking and alcohol, avoid eating fat, chocolate and tea, and avoid having a full meal 3 hours before bedtime, etc. 2.Medication: Routine application of proton pump inhibition (once a day, if necessary, can be increased to twice a day), the course of treatment should reach 8 weeks or more; at the same time can be combined with other drugs such as gastrointestinal motility drugs, gastric mucosa protective agents, H2 receptor antagonists, etc. 3.Surgical treatment: Belsey, Nissen and Hill fundoplication are the three most widely used anti-reflux surgeries in clinical practice. 4.Endoscopic treatment: It is a new technology developed in the past three or four years, mainly endoscopic suture treatment, endoscopic radiofrequency treatment and endoscopic injection treatment. Since GERD is a chronic disease with recurrent attacks, some patients need long-term treatment to prevent the emergence of complications and recurrence, that is, maintenance treatment. Maintenance therapy can be divided into continuous therapy and on-demand therapy. The on-demand group refers to 8-12 weeks of regular medication, and the symptoms are relieved after stopping the medication, which does not affect normal life and work and can last for more than a week, and the acid suppressant can be applied once in 2-3 days when the symptoms recur, and the reflux symptoms can be relieved; while the continuous treatment group refers to the symptoms are relieved when the medication is used, but the symptoms recur within 1 week after stopping the medication, and continuous medication is needed for maintenance. Clinical practice proves that 60% of patients are suitable for on-demand treatment. For patients with severe reflux symptoms, low esophageal motility, older age (>55 years) with anatomical abnormalities (e.g. esophageal hiatal hernia) and more severe nocturnal acid reflux, continuous drug maintenance therapy should be used. Gastroesophageal reflux disease is a chronic and recurrent disease. In addition to long-term regular treatment, a good lifestyle and reasonable diet can speed up symptom control and reduce recurrence of the disease, which includes the following 8 aspects: 1. Elevate the head of the bed Generally, it is appropriate to elevate the head of the bed by 15° (15-20 cm), so that the head and shoulders are higher than the level of the stomach, so that gravity can be used to improve sleep This can use gravity to improve the speed of acid removal from the esophagus during sleep, thereby reducing nighttime reflux. Patients with GERD should have three meals at regular intervals, and the choice of dinner time is particularly important. Stomach emptying time is about 3 to 4 hours, dinner time is too late, sleep when the stomach contents can not be completely emptied, once lying down, the food retained in the stomach is easy to reflux into the esophagus. Therefore, 3 hours before bedtime should not eat. Gastroesophageal reflux disease patients should eat to seven or eight points full. Excessive eating will increase the burden on the stomach and slow down gastric emptying. Food stays in the stomach, the pressure in the stomach increases, and food is more likely to reflux into the esophagus, causing heartburn, acidity, burping, bloating and other discomforts. 3, the diet should be light high fat, high protein and other indigestible food is an important factor in triggering reflux. Fat can delay gastric emptying, stimulate gallbladder contraction and secretion, reduce esophageal sphincter pressure, so try to eat less greasy food, cooking should be steamed, boiled, stewed, braised, not fried in oil. At the same time should also reduce the consumption of raw and cold food. 4, avoid stimulating food coffee, tea, chocolate, mint, onion, garlic, etc. can stimulate the secretion of acid and reduce the pressure of the lower esophageal sphincter, avoid eating can reduce the stimulation of acid on the esophageal mucosa. Due to the existence of individual differences, different patients have different reactivity to the same kind of food. Therefore, patients should make a record of foods that easily cause heartburn to avoid eating the same food again to cause a recurrence of the disease. The actual fact is that you can be able to get a good deal on your own, and you’ll be able to get a good deal on your own. 6, weight control obesity can increase intra-abdominal pressure, increase the pressure gradient of the gastroesophageal sphincter, increasing the incidence of esophageal hiatal hernia, so reducing weight can reduce the occurrence of reflux. 7, reduce factors that increase abdominal pressure Increased abdominal pressure can induce reflux, so you should avoid wearing tight clothes, tight girdle, full meals, etc., avoid bending after meals, heavy objects, and actively treat constipation, chronic cough and other diseases. 8, pay attention to mental health Research shows that divorced or widowed and people with heavy life stress are prone to GERD. Another study also found that exertion, mental stress, anger are more related to the disease of GERD, suggesting that psychological stress may be its risk factors, so you should maintain emotional stability and a relaxed mood.