Mindfulness Intervention for Emotional Distress (MIED) in Patients With GERD

Inclusion Criteria Participants must meet all of the following criteria: 1. Aged 18 to 65 years. 2. GERD-Q score of 8 or higher. 3. Willingness to maintain a relatively stable usual treatment regimen during the study unless medically indicated changes are required. 4. Ability to use a smartphone, computer, or tablet to participate in the online program and complete online questionnaires. 5. Willingness to comply with course training and follow-up assessments. 6. Ability to understand the study and provide written or electronic informed consent. Exclusion Criteria Participants meeting any of the following criteria will be excluded: 1. Alarm symptoms or high suspicion of serious organic disease, including but not limited to progressive dysphagia, hematemesis, melena, unexplained weight loss, anemia, recurrent vomiting, or persistent chest pain without exclusion of cardiovascular risk. 2. Current or previous severe esophageal organic disease or gastrointestinal malignancy. 3. History of anti-reflux surgery, partial gastrectomy, or other upper gastrointestinal surgery that may substantially affect reflux symptom assessment. 4. GERD-Q score greater than 15, or symptoms judged by the study physician to be extremely severe and requiring priority medical evaluation or intensified treatment. 5. Current uncontrolled severe mental disorder, such as schizophrenia, manic episode of bipolar disorder, acute severe depressive episode, or severe substance use disorder. 6. Current suicide risk, operationalized as a score greater than 1 on item 9 of the PHQ-9. 7. Previous systematic participation in MIED, mindfulness-based stress reduction, mindfulness-based cognitive therapy, or another structured mindfulness program.