Brief Answer:
GERD, requires PPIs and prokinetic meds

Detailed Answer:
Hello and Welcome

I appreciate your concern

If the endoscopy and the subsequent biopsy was fine and stool antigen was negative then both malignancy of upper G.I tract and H. Pylori infection are ruled out.
The inflammation suggested on the endoscopy suggests GERD. Long term untreated Reflux disease can lead to changes in the esophageal mucosa leading to a pre malignant form also called XXXXXXX esophagus.
A two week course of PPIs and pro kinetic meds including metoclopramide along with sucralfate and bismuth subsalicylate can be done empirically to assess for improvement on follow up.

This can be particularly helpful if a hiatal hernia was also found on the endoscopy. You may upload the labs to have a better idea. Diet changes to a low fat diet and re checking the cholesterol can be done within 3 months, if still elevated or if there is a family history of coronary heart disease then Statin drugs can be started such as Atorvastatin.

Please consult your doctor before taking any medication.

wishing you best of health

thanks

Dr. M.S. Khalil

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Brief Answer:
24 hour PH monitoring

Detailed Answer:
Hello again,

Omeprazole is a PPI, you are right. Adequate empiric therapy as pointed out in my previous answer, if fails to resolve the GERD and dyspepsia symptoms, requires further workup. By adequate , I mean , addition of adjuvant drugs like metoclopramide along with sucralfate and bismuth subsalicylate.

You can request for 24 hour PH monitoring , to see if there is need to use PPIs further. Clinical judgment would require the decision to focus more on the GERD or gall stones. Fundoplication surgery can be sought if the 24 hour PH monitoring also confirms GERD and excess acid as the cause.

Please consult your doctor before deciding on any course of action.

Thanks.

Dr. M.S Khalil

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