Brief Answer:
GERD, gastritis, gastroduodenal ulcers

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Based on your symptoms, I would like to primarily rule out gastritis and peptic/duodenal ulcers.

Would you please clarify a few things for me?
-where exactly does it hurt when you don't eat? (just below the ribs in the Centre, or near your bellybutton?)

-how long have you had these symptoms?

- do you have any other symptoms? (heart burn, irritated throat, cough, headaches) especially when you have this pain?

-do you smoke or consume alcohol?

-any other medical issues? Medications?

-do you usually eat regular meals?

-any family history of GERD (gastroesophageal reflux disease), gastric ulcers?

I recommend :
- a gastroenterologist consult
- an upper gastrointestinal endoscopy to check for Gastritis, ulcers, H. Pylori infection (causes ulcers) and GERD.
-blood tests (complete blood count, kidney and liver function tests)
-Proton pump inhibitors (like pantoprazole) twice a day, 1hr before meals for 10 days. Further and additional treatment based on test results and clinical findings.

I suggest that you first try radical lifestyle and diet changes and see if it helps
- Have smaller but more frequent meals (every 2-3 hrs).
-avoid caffeine (especially on an empty stomach), at least till the pain goes away. Caffeine, sugar, carbonated drinks, spicy, oily and sour foods irritate the stomach and worsen gastritis.
- avoid smoking and alcohol (if you do)
-avoid refined grains and processed foods.
-include whole grains and fresh fruits and vegetables in your diet.
-Have plenty of water (about 3 litres) throughout the day (distribute throughout the day and increase water intake gradually over a week or so).
*if you have any medical conditions that needs you to restrict water intake please stay within those limits.

-get some exercise (walking outdoors) for about 20 minutes a day (after your doctor gives the fitness for the same)
-Chew your food throughly before swallowing
-don't lie down or sit immediately after meals. Wait for a half hour during the day (for sitting) and 2hrs (for sleeping) at bedtime.
-elevate your head over an additional pillow when you sleep at night.
-milk is a natural antacid. Have cool milk twice a day.
-avoid foods/drinks that are too hot or too cold in temperature.

Please try my suggestions for 2 weeks. You should find some relief (about 30%) which will get better with time.

If it doesn't get better, please consider my recommendations for medical help.

Hope this helps.
Please let me know if there is anything else I can help you with.

Hope you feel better soon.
Wish you good health.
Regards,
Dr. Shuba Hariprasad

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