Efficacy of Gut-Brain Neuromodulators in the Treatment of Gastroesophageal Reflux Disease

Exclusion Criteria

• •Patients with organic gastrointestinal disorders (e.g., celiac disease, inflammatory bowel disease, history of gastrointestinal malignancies);
• •Severe dysfunction of major organs (e.g., class IV cardiac dysfunction, hepatic failure, uremia, respiratory failure) or congenital diseases (e.g., hemophilia, Wilson's disease);
• •Hypersensitivity to study medications;
• •Patients who are pregnant, lactating, or planning pregnancy;
• •Use of monoamine oxidase inhibitors (e.g., linezolid or intravenous methylene blue) within the past 5 weeks;
• •Severe psychological symptoms or cognitive impairment (GAD-7 \>15 or PHQ-9 ≥15);
• •Circulatory failure, central nervous system depression (e.g., acute alcohol, barbiturate, or opioid intoxication), or coma.