Brief Answer:
explained plus Need more info

Detailed Answer:
Hello and Welcome

I appreciate your concern.

Even though your symptoms fit GERD, in any acute episode of epigastric pain and discomfort , EKG must be done to rule out any cardiac issue first.

I would empirically recommend a two week course of a
course of A PPI like Esomeprazole and a prokinetic
like metoclopramide or itopride to see for improvement, if
symptoms persist then an endoscopy will be indicated
to be ultimately decided by your doctor.

To confirm the GERD , you may undergo 24 hour PH monitoring. I would also advise ultrasound abdomen and pelvis and a stool R/E.

kindly let me know your average B.P control , your height and weight. Please list the medications which you are currently using, to guide you better.

Let me know if you have any query

wishing you best of health

Thanks

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Brief Answer:
Explained

Detailed Answer:
hello again,

have gone through your meds.

Long standing diabetes, esp if glucose isn't controlled can lead to gastropathy leading to gastroparesis. Initially it may present as GERD or IBS.

I would advise you to monitor your blood sugar so that your antidiabetics dose can be achieved optimally.

I wanted to calculate your BMI ( body mass index ) by knowing your weight. calculated via weight in kg divided by Height in meters squared to know if you are overweight or morbidly obese so that other choices may be presented.

As far as the treatment goes my answer is the same mentioned in the previous answer. You may add mebeverine if abdominal pain leads the list of most discomfort. combination products such as eucarbon have also shown god results in patients and you may discuss that with your doctor.

let me know if you have any other query.

thanks

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Brief Answer:
explained

Detailed Answer:
hi,

you have a BMI of 54, which is very high.

Lorcaserine is indicated in a BMI of > 30 Kg/meter squared if there is also a weight related co morbid condition like hypertension, dyslipidemia, Diabetes. so you fit the criteria if you have a comorbid condition which I described in addition to the BMI which is high. You may discuss this option with your doctor to help you loose weight effectively.

Diet changes are quite simple that you need to make. Do not complicate them by following complex regimens. Take 5 small meals a day consisting mainly of low carbohydrates , high fiber and low fat ingredients. Participate in 30 minutes of exercise twice daily. Avoid cola, caffeine, ice cream and over processed food as much as you can. Avoid eating after 9 PM at night. Keep a diet diary to record your daily routine for it to make a habit to see how you respond and what progress you make along the way.

Let me know if you have any query

wishing you best of health

Thanks

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