Question: Hello Doctor ,

I am 32 years old . Last 5 years on and off on PPI.
I have chronic GERD and stomach issues.

Last few months I am trying nexium 40.

One year old endoscopy report says Dyspesia , Anal gastritis.
After food at time I feel slightly nauseating, I burp a lot and midnight my main problem starts , when I have to get up as I feel like something is choking my chest or throat.
Life style change improves my condition , but then I have to be really careful.
Normaxin I take rarely at night , if I am unable to sleep due to stomach discomfort (upper stomach) or sweating .
I was asked for ph study manometry , which I have been delaying for a year now.
As I am trying to avoid any surgery. What do you suggest?

1) I was taking Eldervit B12 shots for a year , each month one .B12 level was fine after that.
Last one year i am off the shots. B12 has come down to 448 pg/mL as per the blood report from last week. Would you suggest what brand of B12 I can take now? Eldervit is not available in market.
2) I take calcirol XXXXXXX once in a week now.
3) My MCH blood count is 32.1 pg (slightly higher) , is it ok?
4) Due to acidity I try to avoid Citrus fruits , and I think I am having Vitamin C deficiency. Having bleeding gum issues. right now I have just started taking Bifilac Lozence and Clohex Plus mouth wash for gingivities .

Would you suggest anything in particular for Vitamin C?Taking vitamin Supplements might trigger my IBS symptoms.

And finally , Do you think it is ok for me to continue like this with over the counter PPI ? And trying to reduce them ? Or i should consider the surgery.

Ganaton Total is better or Naxium 40?
Is it ok to have gelusil Syrup now and then when I am trying to avoid PPI?

I was plannign to join some arobics sort of dance at night , 8:30 pm for one hr twice a week? do u think night time exercise can aggravate the GERD symptoms while sleeping?

Taking Penegra or Tazzle for Erectile dysfunction very occasionally , Does it affect stomach problem?

Thanks & regards XXXXXXX

Hello Doctor,

I am not on ED medication now.
Can GERD cause light nausea ?

Would you suggest any light dosage of Vitamin C supplements that I can try to see if it doesnt worsen my IBS symptoms?

So Zintac , Rentac wont be adequate to reduce the symptoms right?

I want to delay the 24 hours pH monitoring test for a year .
And this one year i want to control my diet and life style to see if i can reduce on the PPI and manage a normal life or not.

Is GERD related to my farting and back pain (back pain happens only when my motion is not clear ) and light upper stomach pain ?
Is using Asafoetida in food not good for GERD problem?

Thanks & Regards XXXXXXX