instruction: hello doctor my condition is herd and lor and I am so stressed out with this I cannot even sleep I take esomeprazole 40mg per day but still no improvement I sleep but sometimes acid reaches my throat when I wake up I am on this for one month and I feel every time I take pills that they remain stuck in my throat like down the esophagus and I must drink a lot to push it down I am on diet with no spicy no coffee no alcohol and I have a list with acidic foods I am scared about my esophagus to not be very damaged this will destroy me for real I am only 24 should I double the dose should I change medicines now with the coronavirus I cannot find any doctor I do not feel heartburn but I always hear my stomach making a weird sound when lying in bed please help
output: hello I understand your concern and at this point I would recommend further evaluation in order to better assess your condition I would recommend a barium swallow ray endoscopy esophageal manometry and 24 hour esophageal acid test I would recommend you shift your esomeprazole to ranitidine 150 my twice a day for two weeks and metoclopramide 10 my one tablet four times a day for five days if symptoms persist worsen or new onset of symptoms such as diarrhea further consult is advised I hope this helps