Hi. Thanks for your query. Noted the history and understood the concerns. Since you are a know acid reflux patient at an early age of 22, there may be associated things that need to be diagnosed and treated to be successful in getting rid of the problems. The sharp pulling pains in upper stomach can be due to another causes like gastritis, duodenitis, gall bladder pains and so on. Hence I would advise you the following in such a situation: Get the upper GI Endoscopy done to know the exact position of the esophagus, stomach and duodenum. Endoscopic ultrasonography is a new modality and gives far better diagnosis than the conventional ultrasonography of abdomen. If not available go for ultrasonography of the whole abdomen. Tests of blood for liver functions, pancreas function. Clinical evaluation by a General surgeon along with correlation with the reports can give the best possible diagnosis for proper plan of management. In the meantime get started with proper dosages of a PPI like Pantoprazole, antacid and Domperidone. Soft bland diet. Control of the stress and anxiety is very important.