Hi. Thanks for your query. Noted the history about a male/60 years, GERD for almost 5 years, was feeling ok with one Zantac a day - problems increased hence endoscopy done, Grade III esophagitis, ulceration in mid lower esophagus at 32-38 cm - large hernia with pouch formation, Prolapsed gastropathy on retching, antral gastritis, Deodenitis H. pylori positive - also get back problems, Wants to know the treatment, how long if only on medications, whether surgery is required and whether backache is related to this present problem. As per the history and report of upper GI Endoscopy I would answer and advise you the following: This needs intensive medical therapy in the form of following: Zantac should be taken twice a day Add on PPI like Omeprazole Antacid every three hours. Motility regulator like Domperidone. At least of r one and half months. Get barium studies and manometry studies. If the medical measure fail to give the desired result, go for surgery as would be advised by General Surgeon. Till then have proper medications.