Agree, but usually the luxury of sitting quietly is not possible...

The sitting trick is just a trick which doesn't address the problem.

The acid generated while digesting food is hurting your stomach lining.

It needs to be reduced.

Agree with Dr Pepshihonage... if it's gnawing/burning then more acid suppression is likely required. Either that or if possible try reducing portion size (since acid secretion is stimulated by stomach distention).

I forgot to say that in my case the discomfort is definitely not gnawing - more of a pressure/fullness in stomach sensation which worsens on standing/moving around. For me I'm sure it's mostly hypersensitivity - feeling 'stretching'/distention on gastritis & duodenal scars. Sometimes it's trapped burps. It's sometimes annoying & uncomfortable, but not severe.

I dont think I can reduce acid any more.. Im on 40mg esomeprazole and take ranitidine, but that barely makes a difference. Ant-acids don't seem to make much difference unless Im really stressed.

My portion sizes are already quite small, for breakfast I had about 30g of white fish and 3 small slices of white bread. I wasn't too bad but then when I stood up and walked around the burning in my stomach started.

At the moment the burning has subsided but Ive got bad heartburn, I think all the acid is just in my esophagus

Does this happen with all bland foods? What about with rice, potatoes or oatmeal which might be easier on the stomach than bread & fish?
Any possibility of bile (rather than acid) causing your pain?

I am kind of confused. Do you mean burning is the only thing that happens after you eat or do you get stomach pains as well?

Have you considered switching PPI's? It sounds like you have been on this one long enough to the point of where you should be getting some benefits now.

The gnawing is after eating anything, potatoes, pasta, bread. I can't have rice as the stomach is really painful when I have it for some reason.

It has been like this for the last few weeks, the only relief I get is when I get heartburn, as I guess all the acid is just up in my esophagus. I also feel a lot better on an empty stomach, when I wake up first thing in a morning is the best, I can move around without pain.

It sort of got really bad this weekend. I had some pasta and turkey mince, and ate quite a bit of it and think I overdid it. I also never usually have pasta so don't know if that caused the problem. I went out afterwards and my stomach was pretty painful. Then a few hours later I ate some brioche which seemed ok, but then I had a cabbage juice and started to feel very nauseous. I woke the next day and everything I ate gave me this gnawing. I started taking Carafate again hoping to settle it but haven't noticed much difference.

I think the PPI is definitely working, for example if I eat something slightly acidic like honey or yoghurt my stomach really gets irritated, far worse than eating bland food, and they are only like pH 4-5. If I was off the PPI I think I would be in absolute agony.

I dont know what to do really, its been 3 years since this started and my problems just fluctuate between stomach pain and heartburn. The drugs help but only to the point where I am not in absolute agony, but they don't relieve my pain and discomfort.

Im seeing the GI again on Friday and will see what they say. At this point I wish they would just remove my entire stomach and give me my life back, but thats never going to happen :(

Andy - what was your exact diagnosis? Assuming you had endoscopy.

Also when do you take your meds? This can make a big difference. Also getting on the right ppi & dose is important.

Cabbage or cabbage juice destroys me & I think it's because it increases acid & bile production which is a double whammy of pain for me because of gastritis & duodenitis. Yep, I was duped by the internet hype about it...

Rice used to hurt me too, but fine now. Bread has gone off the agenda though, but that's more an IBS thing.

I noticed what you wrote on other post about relief if you lie on your right side. Me too! I'm sure if I could stay like that 24/7 I'd be fine! Impossible dream though with work & kids...

@smile

Forgot to say, there has been talk of bile reflux, but there has never been any bile during endoscopy, and I dont know of any other way to test for it. Also I would have thought having something acidic would make that better, but my stomach reacts very badly to anything even remotely acidic.

Also my symptoms occur even when I eat no fats.

Im trying the Carafate again atm, in the past not had much success for it but I think its the go to remedy for bile reflux anyway.

My official diagnosis 3 years ago was mild gastritis and hiatus hernia. But I had been off PPI for a couple of weeks and was in absolute agony, so I dont really know if I still have actual gastritis or Im just hypersensitive. I could do with another scope really.

Im careful with my PPI, I take it 30 mins before food on an empty stomach as I've found that works best. If I have it 60 mins or longer before food I feel a big difference. I make sure to have some protein in the meal after too.

I've tried 20mg twice a day and now on 40mg once a day, didnt notice much difference either way tbh.

Cabbage juice is a bit of mystery still, when I first tried it, I found it quite irritating but the results after were remarkable. So I just had to put up with 30 mins of discomfort for much better feeling the rest of the time. Sadly it just doesn't seem to give me the same stellar results now, but I do think it helps..

Did you get tested for H pylori?

My pain worsens with fatty foods, but I think this is extra bile irritating my duodenitis. I don't get any reflux/heartburn.

It's tricky because we all have such varying symptoms, but all have the same stupid label/diagnosis!

Have you tried different ppi's? Omeprazole was useless for me, but Lansoprazole & Esomeprazole work great.

Have you tried mebeverine or buscapan? I initially got these for IBS, but they work great for stomach spasms too.

Have you tried slippery elm or psyllium husk capsules? These are great to absorb acid & bile.

Have you tried Gaviscon? Although guess your carafate is similar.

Have you tried Pepzin GI? Talk to Shihonage about that.

Have you tried digestive enzymes or probiotics?

I was tested for h pylori at the time of endoscopy which was negative. Had others since negative too, but cant be accurate as I cant come off PPIs, too much burning.

I've tried lansoprazole, seemed ok but esomeprazole was better so switched back, especially when they said I couldnt remain on the dose of lanzoprazole I was on.

I'm on a low dose of amitriptyline for the pain, I tried a higher dose but gave me horrible constipation so now Im on 10mg, I also take Mirtazapine for depression but its supposed to speed up stomach emptying as well. Also take domperidone, as little as I can though as it sends my liver tests off the charts.

Im having slippery elm with most meals and it helps, but unfortunately does completely alleviate the burning.

Tried digestive enzymes, anything with protease burns my stomach something nasty. I tried some lipase ones but didnt notice much difference. Tried lots of probiotics and cant tell if theyre making a difference. I take them anyway.

Im on the Pepzin GI as well, have DGL too but tbh doesnt seem to help me much. I think I've tried just about every supplement going - Mastic Gum just burns, ginger sometimes helps sometimes burns, Tums & Gaviscon only really help if Im really stressed.

I've never tried IBS drugs, I dont think I have problems with cramping really, as when I hunch over and compress my stomach it actually makes it feel ok, its when Im stood, or my stomach is relaxed and stretches that I get more gnawing.

You need a good review with your Gastro.

I can't get off the ppi either...well I can for a few months here & there, but not long term, but I'm not going to lose sleep over that anymore. I might try & swap it for Pepcid at some point, but not yet.

Have you tried Chiropractic treatment? I see a good Chiropractor who does a lot of abdominal & diaphragm work on me. On my back he always needs to adjust the vertebrae that supplies the stomach nerves. I'm not saying it's a cure, but it reduces my pain levels hugely. My digestive system just seems to work 'better' afterwards. I'm skeptical of most treatments, but I certainly know when I'm overdue a chiropractic session.

Just an update. Feeling a lot better at the moment, I think something was going wrong with my PPI, I started swallowing a whole tablet of esomeprazole a couple of weeks ago as opposed to splitting it in two and having it twice a day which I'd been doing for the last year. Ive switched back to splitting it in two, but also disolving it in water before drinking as it advises if you have trouble swallowing tablets.

The burning has now greatly reduced and is more of a mild discomfort on my left hand side.

No idea why the whole tablet doesnt seem to work for me given that even in water it disolves within seconds, but glad I've figured it out.