Hi. Thanks for your query. Noted the history and understood your concerns. Your symptoms are due to Hiatus hernia means there is herniation of the gastric mucosa into the esophagus due to lax means loose lower esophageal sphincter which normally does not allow any stomach contents to come up in the esophagus once you swallow anything. When the stomach is empty, even the acid comes up in the esophagus causing the burning pain in the center of the chest and nausea and/or vomiting. I would advise you the following in such a situation: Zantac 12 hourly. Pepcid every 3 to 4 hours when on empty stomach. Add Domperidone or such motility regulators. Soft bland diet. No aerated colas / soda/ drinks. Early dinner. No late nights. Treatment for anxiety (as prescribed / needs a prescription by your Doctor) Lying in a reclining position Walk around after dinner. Think of the factors which increased the present problem, GERD, anxiety and avoid all such factor strictly. No smoking/drinking, if you are doing. It is also observed that there are so many other things like incense sticks - that is agarbatti, dhoopbatti, scents, scented things of any sort, Deodorants and such factors do not allow one to get alright- your observation will help you to find out all such factors which should be avoided at any cost. If no relief, get Upper GI endoscopy done and get prescription for added Medicines.