Question: Brief Answer:
Acute flare up of gastritis.

Detailed Answer:
Hello and thanks for choosing Ask a Doctor service for your query dear,
Have seen your details,
Firstly Nexium 20mg twice daily is a suboptimal dose for an adult.Minimum recommended dose is 40 mg twice daily.
Secondly antibiotics increases acidity by many folds therefore when ever a patient is on antibiotics optimal doses of antacids are recommended.

As off now you seems to be in acute phase of severe gastritis.
Recommendations are-

Nexium can be used in the dosage as high as 80 mg twice daily.Trials have shown that esomeprazole is superior to other PPI's in controlling reflux symptoms. Also, request your doctor to add Domperidone 30mg or Levosulpiride(both are prokinetic)slow release once daily. This will slow down the reflux of acid back from stomach into esophagus.Prokineic should be added in your regimen.

An antacid containing local anesthetic (Mucaine gel ) should be taken 2tsf thrice daily.

Acotiamide is another wonderful new drug and is very effective in controlling symptoms of GERD and esophagitis. In trials- Acotiamide, a gastrointestinal motility modulator, at a standard dose of 100mg thrice daily has significantly affected esophageal motor functions or gastroesophageal reflux in healthy adults.

All these drugs should be given by your gastroenterologist to provide you with relief in your problem.


Once relieved follow a normal diet with optimal doses of medicine.
Its not necessary to eat bland food however foods like junk food over spicy and oily foods should be avoided.
Avoid carbonated beverages alcohol and smoking.
Eat home cooked food.

Things would be in control.
Hope i was helpful,
Follow ups are welcome,
Thank you!

Doctor, I am 39 year old male. I am writing to you talk about my stomach issues. It started in XXXXXXX this year when I had an exam. I had panic attacks and anxiety issues. Then I started having acidity problem. The doctor put me on Nexium 20mg and it seemed to help and I was taking it regularly in the evening. However, in the last week of October I had flu and I was put on Antibiotics and after I finished my course my reflux seemed to become very bad. I am unable to sleep flat as I can feel the acid in my mouth in the morning. Doctor then put me onto RABEPRAZOLE 20mg, morning and evening and asked me to blood test and CT scan of abdomen. Both blood tests and CT scan came back normal. I am on a very bland diet and when very bland it is ok, but even a little different food I get bloating and headache and it takes a while to resolve. I did endoscopy in 2017 and it came back normal. I am starting to get worried and I need proper guidance on what next needs to be done. Currently I raise my bed to sleep which seems to be effective as in not bad burning sensation. eat a bland food, but I seem to be triggered by food that was completely ok before this problem. yesterday and today, I am not sure if it is because of food but I am feeling feverish and tired. any guidance is greatly appreciated.

Hello doctor, Thank you for writing in detail. I will talk the doctor here based on your recommendation. Quick question, is it safe to have Domeperidone and rabeprazole? or just domeperidone alone? Also, to understand is it ok to have acute phase of gastritis for more than a month? should I be very worried or is this something that will resolve with medication?

hello doctor, thank you once again for a detailed reply. my last query to you. Is the indigestion due to acid reflux ? why have become sensitive to foods?