Brief Answer:
Gastritis

Detailed Answer:
Hello

My name is Dr Muhammad Ali Rauf & i will look into your problem.

I have gone through you problem and i concluded that you have recurrent stomach pain. In medical terminology it is termed as Gastritis. As you took medications earlier which improved the symptoms but now they are not being relieved because you did not take care of your diet. You mentioned that you had undergone Upper GI Endoscopy. Did dr took biopsy for H. Pylori associated? H. Pylori is a major cause of gastritis and requires extensive care. If biopsy was negative or not done then management is long term which includes both medical management and general care. If you take care of BOTH only then you can lead a pain free life. Nexium is already on top of the list for this problem. I would suggest you following things:

a. General Care:
It is more important than medical therapy and will decide the outcome of the disease. If you will not take care of this then no medicine can help you.

> Always eat small frequent meals.
> Avoid heavy meal at night (specially fatty)
> If you smoke then try to quit it. If you can't then try to reduce daily smoke.
> If you are overweight then try to reduce some weight.
> Perform daily light exercise. e.g daily walk for a mile in park
> If problem occurs at night then elevate head side of the bed by 8-10 "

*Food to AVOID:
> Chocolates, alcohol
> Carbonated drinks
> Fatty & fried food (if can't avoid then at least reduce intake)
> Caffeine products(coffee, etc)


b. Medication:
> Esomeprazole 80mg/day for 8 weeks
> Magnesium trisilicate/Aluminum hydroxide suspension twice a day for 14 days
> Ranitidine 150mg twice a day

It is a slow process to heal and requires extra effort from your side. You need to be consistent in management. You can take multiple opinions but at the end you need to strictly follow ONE else you won't heal properly. I know that there are a lot of limits being put but they are only for you benefit. Initially you will find it difficult but with the passage of time you will become used to it.

Hope I have answered your query. If you have any further questions I will be happy to help. Wishing you good health

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Brief Answer:
Please see description

Detailed Answer:
Hello

Thank you for writing back. I have gone through your query. I will answer your questions one by one.

1. About diet:
Yes the diet you are taking is good and will improve but with the passage of time. You need to be consistent with diet as well as medication. If one day your symptoms improve and next day you start taking irritating food then you will be causing more problem for yourself.

2. About Nexium:
Let me give you an example to understand. Gastritis is like "fire", nexium is "water" and diet like chocolate/soda/alcohol is "gasoline". Water will reduce fire if consistently poured on fire BUT if you add gasoline then later more amount of water will be required. Similarly in your case nexium initially was treating the gastric acid but after you took diet like chocolate, soda, spices, etc there was more damage occurred resulting in more severe irritation of stomach mucosa and increased acid secretion causing severe symptoms.
Secondly, 80mg/day is the standard dose of nexium which is required by every patient for successful effect.

3. Magnesium trisilicate/Aluminum hydroxide suspension is basically a "basic" solution that neutralizes the gastric acid and relived symptoms rapidly and effectively. It comes under different brand names that is why i gave you generic name.

4. Chances of cure:
In most of the cases permanent cure does occur but depends upon:
> Individual to individual.
> clearing the cause of problem. e.g if irritating food is the cause of problem then after removing the irritating food condition starts improving with time.
> Taking general & medical care
> Avoiding stress. Stress in a very important factor. Stress results in increased release of acid causing symptoms.

After the cause is removed, mucus membrane over the stomach wall regenerates and with the passage of time cures completely.


Conclusion:
Yes it can be cured but for that you need to be determinant. Be consistent with medication & general care. Meanwhile if you think that pain is more severe then you can visit hospital for i/v treatment temporarily. i/v treatment will act more rapidly as compared to oral medications. Later on you can continue the oral medicines.


Hope I have answered your query. If you have any further questions I will be happy to help. Wishing you good health.

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