Dear Sirs/Mesdames,

Seven years ago, I had an esophagogastroduodenoscopy with the following diagnosis:

Hernia hiati oesophagei
Gastropathia erythematosa (gr. Mediocris)
Cascada ventriculi

I was then prescribed Controloc 40 mg every 2 months. The condition improved (heartburn and abdominal pain stopped) while taking the therapy, but soon after the heartburn recurred. I tried to correct the condition (according the advice of several doctors) with a diet, teas and some natural preparations, but the heartburn was still present and could not be neutralized without medication (Controloc or Ranitidine, and for immediate help Rupurut or Gastal). In the meantime, I was recommended another two-month therapy with Controloc (2016), NERD was added to the existing diagnosis, but after that the condition remained unchanged, mostly heartburn, without major problems.

Over time, the condition stabilized in such a way that I occasionally took Controloc 20 mg as needed (sometimes for 3 days, but very often it would have been once a week, and even happened for 20 days without medication) until late last year. There have also been periods with certain difficulties over the past five years (chest pain or mild abdominal pain, sometimes in the upper back, very rarely brief sharp abdominal pain). On one occasion, despite the daily Controloc, I got heartburn and an inexplicably heavy feeling all over my mouth to stomach, a kind of blockage of the entire upper gastric system, with no appetite. I had to seek emergency medical help and after receiving an infusion and a few days off, everything calmed down (then I was prescribed Nexium). Everything continued as previously described (Controloc 20 as needed), except that I occasionally had periods without Controloc, using Ranitidine. I have been eating normally all the time, without a special diet; I avoid garlic, peppers and strong spices.

In the middle of last year, although I had periods of 20 days without Controloc, I would have occasionally experienced mild and vague nausea, and at the end of last year the long-term stable period ends, PPI has been needed more often, and mild nausea has been more common. I tried to replace Controloc periods periodically with Rabeprazole (since we no longer have Ranitidine available) and I felt relatively good, but I have been using PPI almost daily.

I am currently using Nexium 40 daily, I have no heartburn or pain, but the feeling of nausea is more and more present. I have no vomiting, the stool is mostly OK.

Please advise. I believe that gastroscopy should be done again, but I am not able to do that at the moment (I am abroad where health care is not very high), so I would ask for a recommendation of some medicine that could possibly help me or for some other useful advice.

Thank you in advance.