Brief Answer: Need strong efforts and strict measures.... Detailed Answer: Dear XXXXXXX I am a Physician associated with expert gastroenterologist for more than 5 years; and as your query is unattended for sometime now, I'll take this opportunity to answer on behalf. We see such patients on regular basis in our outpatient and I understand how frustrating and troublesome this issue can be. Well, GERD and indigestion present with myriad of symptoms spread across the entire intestines and sometimes beyond it. The symptoms you describe, may be except for the libido, can all be explained by GERD. It is clear that you have looked into all corners / all medical system to treat it; but these drugs are usually symptom relief measures. You will need to put in some efforts and modify the life style for better results. I suggest the following measures that has worked in many of my patients with GERD. 1. Be specific with the food you eat. It's very clear that you don't tolerate spices very well. Make a point to avoid it completely. If you do plan to include them in your meal, make sure you take some antacids atleast an hour before the meal. Syp Gelusil MPS works very good. You can take them. 2. Besides spices, I would also suggest that you avoid caffeinated beverages including coffee and tea. Avoid smoking and alcohol drinks too. 3. Make sure you eat at regular and timed intervals. If possible you can divide your day into 6-7 intervals for small meals. Frequent and small quantify food gives less work to your intestines. 4. Prefer to take your dinner well before you hit the bed. I recommend my patients to time the dinner couple of hours before going to sleep. 5. Give yourself plenty of fibre rich food and supplement it with adequate fluids. They reduce the load on intestine movements. 6. Start your day with exercises. Morning walks, yoga and meditation is strongly recommended in such cases. 7. Keep yourself away from physical and mental stressors. I recommend that you talk to experts if stress have significant role to play in your life. 8. It's important that you give your body enough rest after days work. Make sure you sleep atleast for 6 hours at a stretch. Talk to experts if you aren't able to manage this. With these 8 steps, I also put my patients on a brief course of proton pump inhibitor drugs. Nexpro (esomeprazole) 40mg tablets once a day before breakfast for 2-3 weeks is an effective regimen. Discuss with your treating doctor. I would also like you to discuss about possibility of hypothyroidism and related medical conditions including H.pylori infections. If your doctors haven't looked into these disorders, it's worthwhile to ask for more tests. Hope this information is suffices. Let me know if you need more information. Regards

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Brief Answer: Gastric biopsy... Detailed Answer: Dear XXXXXXX Apologies for the late reply. I was away from the internet due to my father's surgery. I thank you for your patience. H.pylori infection is suspected clinically in a person suffering from long standing gastritis and GERD. If your doctors also suspect this infection there are few options of tests to confirm this infection. The tests include: 1. Gastric biopsy through an endoscope - This test is widely done in Indian health centres. 2. Urease breathe test 3. H pylori antibody blood tests 4. Stool tests to detect H pylori As described above, in India we commonly combine endoscopy with gastric biopsy to rule out H pylori infection. You can discuss about this infection with your treating doctor and plan for investigations if needed. With improved diet and lifestyle your medicines will produce better results. Hope this helps. Regards

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Brief Answer: Stomach cancer excluded by endoscopy.... Detailed Answer: Dear XXXXXXX I am very pleased... atleast some of your symptoms have resolved. Well gastritis and GERD is termed as life style disorder/condition by most physician. H pylori infection and other conditions can contribute to it. If you felt better with H pylori kit, perhaps you need to follow the regimen for some more time. You will feel better. Besides that treating this infection now doesn't make sure you will not have GERD / gastritis in future. You need to keep up the dietary and life style changes suggested to remain healthy. As far as stomach cancers are concerned, do not be worried. Endoscopy is the test of choice to exclude cancers. You were tested; and your doctors did not find anything alarming. Therefore in all probabilities, I consider that cancers are ruled out. Hope I have answered your questions. Let me know if you need clarifications. Regards

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Brief Answer: Feel free to write back.. Detailed Answer: Most often if food pipe, stomach and intestines appear grossly normal, tissue samples are not biopsied. Scopist need to visualize abnormal tissues from where samples are picked. Do not be concerned now. Possibilities of cancer is least likely. You are free to ask me in future; I will be available here. Good luck and regards!

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