Q. Persistent problems related to GERD and gastritis with sleep disturbances. Please help.

Answered by
Dr. Anshul Varshney
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Sep 02, 2020 and last reviewed on: Sep 07, 2020


THE FOLLOWING ARE OBSERVED SINCE LAST 4-5 months Age:54 years,Weight:62.3 Kg,Height:158 CM

1. Anorexia- loss of appetite 2. Dyspepsia-difficulty in swelling during taking food/water 3. Eruptation at any time mainly after taking food. 4. Acid Burn-Presence of Mucin outcome 5. Presence of GERD 6. Sleep Disturbance-in a interval around 2-3 hours after sleeping without any reasionable significance. 7. Weight Loose from 72 Kg to 62.3 Kg within 3-4 Months 8. Helicobacter pylori infection positive. 9.U.G.I Endoscopy Pan Gastritis


1.She has past history of piles (Bowel: Constipation). 2.She has past history of feeling of Lump in throat occasionally during taking food. 3.She had suffered a head injury in the last month and she is now complaining of weakness & dizziness.

Current Treatment Current Medication:(Please refer to the attached files for details) 1. Aristozyne (Digestive Enzyme)-for 60 days-3 times daily 2.WelLiv Syrup(Liver)-for 30 days-2 times 3.Acid El Dervit -ZC(Folic )-for 30 days-1 tab per day

Above: Above are already taken for 15 Days

1.Vegazod for 60 days- 1 tab daily 2.HAPPI TM-IT(Rabeprazole-20mg & Itopride-150 mg capsul)-for 60 days-1 tab daily Above are already taken for 30 days


I have studied all the reports you have sent to me.

Important things are :

1. Pangastritis 2. Solitary Rectal Ulcer. 3. Anemia.

Since she has persistent problems related to the GERD and Gastritis , this can aonly be resolved with drugs she is taking like pantoprazole. I recommend a combinatipn of Pantoprazole with Domperidom which will help in GERD. At this age , she has significant weight loss , that can not be neglected. I would like to know that she has anorexia , or she has fear of eating due to gastritis symptoms post meal?

You have not mentioned about her Blood Pressure , ECG , Chest Xray.

My most of the concern is about her weight loss , as at this age at could be malignancy.

Please do tell me her menstrual history , i also advice you for her breast examination (self or by a gynecologist/surgeon) to see for any lump. I also advice you to discuss add to her a drug called as Escitalopram (SSRI). Please review with the above. Thanks


1. A combination of anti gastric (Omido) and antiemetic drug was taken for a month but no significance relief observed.
2. B.P-130/83, Pulse: 74
3. I would like to know that she has anorexia, or she has fear of eating due to gastritis symptoms post meal: Only due to anorexia. No fear observed.
4. ECG-Not Done
5. Chest Xray: Refer to the attached report (AP & LAT view).Rest sides are not taken.
6. Malignancy: There is no any breast lump. Please advice for necessary test for weight loss.
7. BIOPSY Report attached.
8. Menstrual History: Her menopause has been started before ten years.
9. Please tell the necessity of SSRI. We don’t observe any dispersion on her.

Current Observation:

1. Mucin out coming through nose is increasing (Mainly During taking food),
2. Eruptation: Increasing day by day mainly after taking food but it comes at any time.
3. Mucin out coming through mouth: Decreasing after medication and GERD also decreasing
4. Sleep Disturbance Continue.
Kindly suggest the other requisite department to consult if required.

Everything seems to be realted to "Acid peptic disease"

Solitary Rectal Ulcer has to be kept into consideration , at present , the report doesn't suggest any sign of malignant ulcer , but we should mark it , and follow it up after 6 months.

I don't find any reason to get her into more investigations , and consulting another specialist for this problem , since she has already been evaluated by specialists.

You should know that sleep disturbances and stress , increases acid peptic diseases and GERD.

So, i want her to sleep peacefully , i don't mind adding a drug to her for her sleep problems. If she takes good sleep , you will notice a lot of improvement in her symptoms.

Now your other question about SSRI. SSRI are used for treatment of depression , but they have other roles in other diseases too. i find SSRI or drugs like amitryptilline very effective in Acid peptic diseases. Infact i have seen , in one of your prescriptions , that she was prescribed Tab Tryptomer 10 mg , i don't know , she took it or not , or she got some benefit or not.

So, consider giving her SSRI , and some people get a good sleep with SSRI , so if she gets , it's a good thing , if she doesn't i suggest an addition of drug like etizolam.

I hope i am able to solve your query , still if you have any query , please ask me. Wish her a healthy life. Dr Anshul Varshney

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