instruction: hello doctor I have severe heartburn difficulty in breathing gas pain and burping please suggest
output: hello I can understand your troubles regarding heart burn and difficulty breathing you are having herd gastric esophageal reflux disease and indigestion obesity smoking drugs pregnancy abc complete blood couont ash thyearoid stimulating hormones end esophagogastroduodenoscopy pyloric infection herd dyspepsia capsule esomeperazole 40 my 0 before 30 minutes of meal for 10 days then follow me syearup gaviscon 20 my after every meal maintain a healthy weight excess pounds put pressure on your abdomen pushing up your stomach and causing acid to reflux into your esophagus stop smoking decreases the lower esophageal sphincter ability to function properly elevate the head of your bed if you regularly experience heartburn while trying to sleep place wood or cement blocks under the feet of your bed so that the head end is raised by to inches if you cannot elevate your bed you can insert a wedge between your mattress and box spring to elevate your body from the waist up raising your head with additional pillows is not effective do not lie down after a meal wait at least three hours after eating before lying down or going to bed eat food slowly and chew thoroughly put down your fork after every bite and pick it up again once you have chewed and swallowed that bite avoid foods and drinks that trigger reflux common triggers include fatty or fried foods tomato sauce alcohol chocolate mint garlic onion and caffeine avoid tight fitting clothing clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter follow after seven days