Abstract: The refluxate(corrosive, irritative and immunoreactive)of gastroesophageal reflux disease(GERD)patient can not only reach the esophagus, but also reach the connected reflux passages, such as oral cavity and airway, and then cause symptoms, complications and terminal organ effects. The typical symptoms of GERD such as acid reflux, heartburn are usually easy to identify and treat, but there are still about 30% of the patients have persistent and proton pump inhibitor(PPI)intractable GERD symptoms. In addition, the atypical symptoms or extraesophageal symptoms of GERD such as chronic pharyngitis, cough, asthma, chest pain are not only very harmful but very common, however people often don’t associate these symptoms with gastroesophageal reflux which derives from the gastrointestinal tract as the etiology, thus easily lead to the misdiagnosis of GERD. The comprehensive examinations to confirm the diagnosis of GERD are needed for these patients, to help guidethe subsequent accurate treatment of GERD. The key to the accurate diagnosis of GERD is to master the PPI test, gastroscope, laryngoscope, contrast, reflux monitoring, high resolution pressure and pepsin test.

Key words: gastroesophageal reflux, proton pump inhibitor, gastroscopy, reflux monitoring, high resolution manometry