Your symptoms suggest long-standing acid reflux with duodenitis, and the biopsy findings plus fatty liver need careful management. A gastroenterologist can guide you with the right medicines, dietary adjustments, and tests to prevent further damage. I recommend avoiding trigger foods, eating smaller frequent meals, and arranging a specialist consultation for a tailored treatment plan and possible endoscopy follow-up.
Hello jyotirenjan ,
Am sorry to hear about your longstanding struggle with GERD,
Follow the instructions below with the Advise from your Ganstoentrokogist, 1.Have small and frequent meals 2.no water during or just after the food intake 3.low fat and less spicy diet 4.do exercise ( waking or jogging) improves digestion 4.take dinner at lest 2 hours before bed 5. Include Curd ( yogurt with probiotic) in the diet
Kindly revert back with your queries and if have any doubts with medication which you may already taking
Hello Jyoti Chronic hyperacidity / possible hypergastrinemia (due to G-cell prominence, which means your stomach may be producing more gastrin leading to more acid)
It can be reactive (from chronic inflammation like duodenitis or H. pylori infection)
Diet
Eat small, frequent meals instead of large ones.
Avoid: fried food, spicy food, citrus, tomato, onion, garlic, chocolate, coffee, tea, carbonated drinks.
Prefer: plain dal, khichdi, boiled vegetables, soft roti, oatmeal, bananas, papaya, curd (if tolerated).
Lifestyle
Don’t lie down for at least 3 hours after eating.
Sleep with your head elevated (extra pillow or wedge).
Avoid tight belts and bending forward soon after meals.
Investigation H. pylori testing (if biopsy didn’t already include it)
Fasting gastrin level to see if acid production is abnormally high
Upper GI endoscopy follow-up every 2–3 years to check for complications like Barrett’s esophagus
Medication Pantop 40 mg morning empty stomach (not life long) Sucralfate suspension before meals to coat and protect the lining
Consult gastroenterologist for better treatment
Acid reflux and chronic duodenitis, along with the prominence of G cells from your biopsy, suggest a complex interplay between stomach acid production and inflammation in your digestive tract. G cells, which produce gastrin, can lead to an increase in acid secretion; this, combined with your fatty liver and dietary symptoms, suggests that both lifestyle and medical interventions may be warranted. First, the connection between your diet and symptom relief should be emphasized: consuming a plant-based or vegetarian diet with reduced fat content might be beneficial, as these foods are less likely to stimulate acid production. Avoid spicy, fatty, or fried foods, along with caffeine, alcohol, and tobacco, which can all exacerbate symptoms. Eating smaller, more frequent meals throughout the day might also help, as large meals can put pressure on your lower esophageal sphincter, aggravating reflux.
For medication, proton pump inhibitors (PPIs) like omeprazole or esomeprazole are often effective in reducing stomach acid and helping heal the esophagus and duodenum. Your doctor might also recommend H2-receptor antagonists or antacids for immediate relief of symptoms. Because your symptoms are chronic and impact your quality of life, it’s essential to have ongoing consultation with your healthcare provider to tailor a treatment plan, potentially including tests for stomach infections like H. pylori which could explain the prominence of G cells and inflammation.
Incorporating lifestyle modifications such as elevating the head of your bed, avoiding lying down immediately after meals, and maintaining a healthy weight can also help manage symptoms. Given your persistent chest pain and burning after meals, it’s vital to rule out cardiac causes and get further evaluation if there’s any uncertainty. Keeping a diary of symptoms and food intake might also help identify and manage triggers. Regular follow-up with a gastroenterologist is advisable to address complications like Barrett’s esophagus or to adjust treatment if symptoms worsen.
