Brief Answer:
It could be gastroesophageal reflux disease

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.

Looking at the medical history and query, my opinion is as follows:

1. Esophagitis at present appears to be due to gastro esophageal reflux disease.

2. It is due to acid in stomach moving up into esophagus due to weakness of esophageal gastric sphincter.

3. Once the sphincter is tightened and acid production is reduced (along with reduced abdominal pressure or reduced pressure in stomach), the symptoms will reduce.

Due to continuing irritation and reduced sphincter activity, you could feel nausea. It will slowly reduce, once the treatment is started.

Non-pharmacologic therapy includes:
a. Avoid spicy foods, beverages, alcohol, smoking, coffee etc, which increases acid production.
b. Weight reduction if overweight
c. Avoid getting into lying down position immediately after food. Taken food atleast 2-3 hours prior. Also avoid overeating, take small multiple adequate meals to reduce abdominal pressure. If required, raise the bed level to reduce reflux.
d. Have regular good sleep and reduce stress.

Pharmacological therapy includes:(As it is distressing, do start at the earliest)
a. Antacids, when pain is severe
b. Proton pump inhibitors like omeprazole help in reducing acid production and helps in healing of esophageal inflammation, and thereby reducing pain.
c. During early stages, prokinetic agents like metoclopramide or cisapride can be used for short time as it strengthens gastroesophageal sphincter. (Do not take for more than 10 days, as they have adverse reactions related to nervous system)

Do take the prescription from your doctor.

Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM

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Brief Answer:
Yes, curable. Cause needs to be identified.

Detailed Answer:
Hi,
Thanks for asking again.

Esophagitis is only inflammation of esophagus. If the cause is treated, it is completely curable.
The cause here is possibly the acid reflux from the stomach. Once it is under control, it will be slowly heal. I am assuming the ulcer is on the lower end of esophagus, if it is in middle or upper location, cause might be different.

If its on the lower end of esophagus, you might have to take the medication of omeprazole twice. (Dosage increase is necessary, as it is not helping) Alternately you can go for next generation proton pump inhibitors. Do meet your doctor for prescription.
Sphincter is an anatomical structure, which is like a door in a natural passage. It opens from one end to let the contents (eg: food) and afterwards closes. However, in reflux disease, the stomach contents can move back into esophagus causing esophagitis.
Along with non-pharmacologic therapy, you need to add a prokinetic agents (for a very short period to allow esophagus inflammation to heal) to improve sphincter control.

If you are not sure about the report, do attach it. Continue both the therapies.

Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM

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Brief Answer:
Do follow both pharm and non pharm therapy

Detailed Answer:
Hi,
Thanks for asking again.

Sorry to confuse you. When i said ulcer, i meant inflammation. If inflammation persists, it could lead to ulcer. The biopsy report is usually available within a week maximum. When you meet your doctor again, you can ask for the report.

Heart burn is same as gastro esophageal reflux disease which leads to inflammation. All are same. Inflammation is causing the pain. Once the reflux reduces, either through anti emetics, or prokinetics along with proton pump inhibitors, everything will get back to normal.

Frequent vomiting could cause damage and inflammation in esophagus. However, try small meals along with both non-pharmacological and pharmacological therapy. Vomiting is possibly due to gastritis and the same treatment can be continued.

You are welcome.
Any further queries, happy to help again.
If you do not have any further queries, you can close the discussion and rate the answer.
Dr. Prakash HM

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Brief Answer:
Reduce stress. Take cold milk.

Detailed Answer:
Hi,
Thanks for asking again.

The stress is increasing the acidity, which is getting in to the esophagus causing further inflammation. You need to relax, it will reduce pain.

You should be more in upright position rather than in lying down position, when awake.

Severe symptoms would be ulcer formation, when can present as bleeding. Your stools would be tarry black (if not on iron therapy) or you might vomit blood stained contents.

Try taking cold milk or ice cream, it should give a soothening effect. Also antacids should be useful.

Importantly, thinking about it will increase stress and more pain.
Any further queries, happy to help again.
Dr. Prakash HM

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Brief Answer:
Yes, you will get better.

Detailed Answer:
Hi,
Thanks for asking again.
Yes, you will get completely better and eat burgers.
You have to follow everything religiously both pharmacological and non pharmacological therapies. Follow seriously for two months.

The inflammation can lead to severe tenderness in chest and back too, and if severe, you could feel whole body weakness too. Follow medication and diet strictly. Importantly relax.
After two months, you can be as you want.
Hope it helps.
Any further queries, happy to help again.

If you do not have any further queries, please close the discussion and rate the answer.
Dr. Prakash HM

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Brief Answer:
Take antacids and cold water.

Detailed Answer:
Hi,
Thanks for asking again.
Nausea is due to
1. Inflammation in esophagus and esophagus trying to relieve itself and associated contractions. As it stops contracting due to tiredness, you will feel less nauseous. It will be on and off, varying with pain.
2. Sphincter weakness and acid reflux increasing the inflammation.

Pain will be present until inflammation is present. You can take something cold like milk or cold water or ice cream to reduce pain. Hopefully, you increased or taking twice proton pump inhibitors. It should reduce acidity. Relax and avoid stress. Go for a walk if possible.
When you meet your doctor, do ask for biopsy report.
Hope it helps.

Any further queries, happy to help again.
Dr. Prakash HM

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Brief Answer:
do not worry. relax

Detailed Answer:
Hi,
Do not worry. I am sure, your doctor would have called you. Needed only a biopsy confirmation, so that we can aggressively treat acidity.
If you are not meeting him very shortly, you can take it PPI twice daily. It is an over the counter drug. If you are meeting, you can discuss and finalize. Do not take tension. Relax.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM

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Brief Answer:
you can take twice daily.

Detailed Answer:
Hi,
Thanks for asking again.
Yes. You can take it twice daily. Should reduce acid production. It is also available without prescription. Take it for at least a month to notice improvement.
Do elevate your bed or use pillows at night to avoid night exposure of esophagus to acid. Symptoms should improve.
Avoid being in lying flat position for long.
Avoid stress.
Follow all therapies advised earlier.
Any further queries, happy to help again.
If you do not have any further queries, do close the discussion and rate the answer.
Dr. Prakash HM

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