Brief Answer: Problems are apparently due to stomach infection Detailed Answer: Hi there, Thanks for your query. Firstly, in order to PINPOINT the exact cause of your mother's problems; give you a SOUND professional advice; and, TRUE VALUE FOR YOUR MONEY, I request you to kindly provide additional information as follows :- # Does your mother have frequent episodes of diarrhea with episodes of constipation? # Is she passing through constant mental stress, anxiety, irritability, forgetfulness, depression, constant fatigue, sleep disturbances, low appetite? # Has she gained weight significantly in the past few months/years; excessive hair-fall; constipation, dry skin, deepening/huskiness of voice? # Does she have frequent headaches or migraine? Nevertheless - pending receipt of additional information - the commonest cause of long-standing gastritis and GERD, is infection of the stomach and early part of intestine by a bacteria called H.pylori in 80-90% of the cases. Further, in my vast clinical experience, treatment of infection has lead to permanent cure in almost 90% of the cases. I therefore, STRONGLY RECOMMEND that she takes 2 weeks' course of a combination of (a) anti-H.pylori therapy, along with (b) a Pro-kinetic drug, such as, Domperidone or metoclopramide; --> FOLLOWED BY, w.e.f. DAY 15, 3-4 months' regular anti-acid drug, such as Esomaprazole or Rabeprazole. Also, deworming course (Albendazole 400mg daily for 3 days)- repeated every month, too will be of great help. I am fully confident that your mother will be FULLY cured of her gastritis and GERD! * Levosulpride ALONE, will NOT cure GERD. * Regarding prescription of anti-depressants + other drugs by her treating doctor, I CANNOT comment on this aspect until I go through additional information as requested. Perhaps, her treating doctor had either:- - found symptoms suggestive of depression with anxiety in your mother; or, - concluded that- in addition- she was also suffering from Irritable Bowel Syndrome, a condition in which anti-depressants have a role. * I will be able to reach to a conclusion once I receive a feedback from you, as advised above. Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion and clinical acumen; and, prescribe treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. IN ANY CASE, I will be looking forward to receipt of additional information (with as much details as possible) as requested. Fond regards and have a nice day, Dr. Rakesh Karanwal

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Brief Answer: Anti-depressants NOT indicated! Detailed Answer: Hi there, Nice to hear back from you. Medical ethics prohibit me from questioning her treating doctor's wisdom or reason to prescribe anti-depressants. However, if I were her treating Physician, I would have limited my prescription to anti-H.pylori therapy, as elaborated above. You may discuss with her doctor and ask him the reason for prescribing anti-depressants. That's all I can say! MY RECOMMENDATION/ADVICE regarding anti-H.pylori therapy still remains valid. Incidentally, I have treated thousands of similar cases in my 33 years of vast experience, with 100% SUCCESS. Take care, Dr. Rakesh Karanwal

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