Consult a gastroenterologist to review your previous endoscopy and current symptoms. Get an H. pylori stool antigen test or urea breath test to confirm eradication. Testing should be performed at least 4 weeks after antibiotics or bismuth and after stopping proton pump inhibitors (PPIs) for 2 weeks, under medical guidance, to avoid false-negative results. Your doctor may recommend a supervised 4–8-week PPI course for GERD symptoms. Repeat endoscopy is not routinely necessary for uncomplicated LA Grade A oesophagitis, but may be indicated if symptoms persist despite treatment or warning signs develop. Avoid repeating H. pylori antibiotics without confirmation of persistent infection.

Eat smaller meals, avoid overeating, and identify foods that trigger your symptoms. Avoid lying down for at least 2–3 hours after eating. If you experience nighttime reflux, elevating the head of your bed may help. Seek medical attention if you develop difficulty swallowing, persistent vomiting, unexplained weight loss, black stools, vomiting blood, or severe chest pain. My recommendation: An H. pylori eradication test is the most appropriate next investigation because you never confirmed successful treatment. A repeat endoscopy can be considered if symptoms persist despite appropriate therapy. Most patients with mild oesophagitis and a hiatal hernia can be managed effectively with medication and lifestyle modifications. Wishing you a speedy recovery!