Brief Answer:
Gastritis with acid reflux.

Detailed Answer:
Hello Mr XXXX,
Thanks for choosing HealthcareMagic for your query.
I am a Gastroenterologist and would be answering your query.
Have gone through your details and i appreciate your concerns.

As per your query answers are-
Most like Mr Sarkar is having Gastritis with severe reflux problem.It can be due to peptic ulcers also.A peptic ulcer is usually found in the duodenum, or the first part of the small intestine. These ulcers can also be found in the delicate stomach lining near this region. These are usually painful sores that are caused due to too much acid production in the stomach, as well as excessive smoking and alcohol consumption. The symptoms generally include heartburn, bloating, nausea, vomiting, and even blood discharge in stool and vomiting.Waking up at night with chest burning or pain is one of the classical features of patient having duodenal ulcers.
This line penned down by you- to the Civil Hospital OPD and Doctor give me Acilock and D-pass injection and it provide immediate relief -response to antacids and acid lowering drugs again clinically confirms the above mentioned diagnosis.

- "I again suffered from aforesaid problem. Now my appetite also decreased and after eating meals I feel something has stuck in my food passage. Every night a fear of death grip me"

Classical tell tale symptom of patient of acid reflux. GERD is a condition in which stomach acid travels up the esophagus, which can then create ulcers and scars that constrict the esophagus. Classical complaint of patient is that he/she can feel something is stuck in throat.Achalasia is a relatively uncommon condition that is often mistaken for acid reflux.It is a disease that effects the esophagus, specifically the junction between the esophagus and the stomach called the lower esophageal sphincter (LES). Achalasia is a condition where the valve (LES) fails to open.It is very common in patients with poorly controlled reflux disorders.

Tests suggested are-
Manometry-This test allows to determine if muscle disorders exist in the esophagus, thus making it difficult to push food and liquids down into the stomach.
Endoscopy repeat should be done to see the condition of ulcers.


Now lets move to MR SARKAR'S treatment-
See as the name suggests ACID REFLUX should be treated in two phases-
1)Control production of acid-For which he would be given proton pump inhibitor Rabeprazole.
2)To prevent the acid formed inside stomach to reflux back into esophagus-I would suggest you to add Levosulpiride. Itis a prokinetic drug and is very effective in controlling reflux of acid back into esophagus.A better way is to take it with Rabeprazole trials have shown that its very effective when combined with Rabeprazole.

3)Sucralfate is used to treat and prevent l ulcers.Sucralfate works by forming a coating' over the ulcer. This protects the ulcer from the acid of the stomach, allowing it to heal. Sucralfate is best taken with water on an empty stomach 1 hour before meals and at bedtime. It should be taken daily by him and would help in healing ulcers.


General precautions are-
As him to Follow a bland diet (low acid levels, low in fat, not spicy)
Eat frequent, small meals.
Lose weight.
Avoid the use of alcohol, tobacco, and caffeine.
Do not eat food less than 2 hours before bedtime.
Raise the head of the bed before sleeping.
Avoid clearing of the throat.



To sum up-(I thik you are in XXXXXXX you would get these medicines at any pharamacy near you)
Capsule rablet l once daily at 7 a.m
Syrup mucaine gel 3 tsf thrice daily before bf,lunch and dinner.
Syrup sucralfate 1gram thrice daily with half cup of water(before bf,lunch and dinner).

As there is no Gastroenterologist at your place just follow these 3 medicines for 15 days and report me how he feels.This is providing a umbrella coverage against acid production reflux and ulcers irritation.


Hope i was helpful.
Feel free to ask follow up.

Thanks.

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