Brief Answer:
Most likely gastric issues.

Detailed Answer:
Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query,

As per your query i think the pain s reated tp gastritisor other gastricissues.

Firstly i would suggest you to switch over to Nexium(Esomeprazole),Initially take it 40mg twicedaily,However if not relieved doses can be increased to 8omg twice daily.

Other then that ask your gastroenterologist to add Prokinetic drug like
Levosulpride.It is a sulpride isomer and exerts its prokinetioc effect by blocking D2 receptors,Recent studies have shown that combining it with Rabeprazole has shown good effect in patients suffering from gastritis.
Domperidome-Very effective in treating GERD when combined with Rabiprazole.

Acotiamide-Trials showed that 30mg doses taken for 3 month thrice daily were highly effective in treatment of of functional dyspepsia.The positive effect of acotiamide on both gastric emptying and gastric accommodation,Gastric accommodation and gastric emptying in acotiamide group were significantly enhanced in people taking it.

-Baclofen- normally used for cerebral palsy patients and patients with other neuromuscular diseases.It has been successfully used in patients with reflux.It may decrease the frequency of relaxations of the lower esophageal sphincter and therefore decrease gastroesophageal reflux.

Please discuss all these options with your gastroenterologist.
Test advice-
Endoscopy to examine the inner part of the esophagus.
Ambulatory acid test for monitoring the amount of acid within the esophagus.


Apart from that drastic life style modification and dietary changes are required-
Firstly stop taking soda or any aerated beverage.
Food and beverages like chocolates, fatty food, coffee, alcohol and peppermint should be avoided in order to reduce the weakening of the lower esophageal sphincter. Several food items irritate the damaged esophageal lining and should also be avoided. They include citrus fruits, tomato and pepper.
Smoking cigarettes results in weakening of the lower esophageal sphincter and should be stopped to reduce acid reflux
-Take about 30 grams of fibre's daily in your diet.Eat one cup of fresh fruits(except banana) and half bowl of green salad daily;this will meet your extra total fibre requirement.Avoid cirus fruits as they can increase symptoms.
- Avoiding alcohol.
-Exercise daily for 20 minutes at least.
-Avoid oily and spicy food.
-Drink COLD milk.
-Yogurt is a very good natural source of probiotic take it daily.
Adhering to both medicines and Strict life style changes will help you in long term.
-Last but not the least ,Keep yourself fully motivated.
I hope I was helpful. I am happy to help if you have follow-up questions.
Regards.

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Brief Answer:
Yes start those medicines.

Detailed Answer:
Hi dear,
Yes start taking medicines for gastritis like PPi's and Bismo peptol and see how you respond it it.
Follow up after 24 hours.
Regards

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