As you have used PPIs alot let me just give you some daily activites lifestyle modification tips
1.lose weight ( if
overweight) divide your weight to the height in meters twice and if the result is more than 25 reduce the weight.
2.Avoid alcohol, chocolate, citrus based fruits,tomato based products
3.avoid pepper mint coffe and possibly the onion family
4.eat small freequent meals rather than large meals.
5.wait at least 3 hours after the meal to lie down or sleep.
6.refrain from ingesting food (except liquids) with in 3 hours of bed time.
7.eleate te head of your bed at least 8 inches
8.avoid bending or stooping positions
9.dont use nsaids
10.dont smoke
11. have a proper sleep routine
12. use
cold milk as drink avoid all hot beverages and carbonated ones
i wont talk medicines here
but if these tips didnt help then ask me again and we will step up
Regards
Dr Shafi Ullah Khan
My patient Is My family