I am Dr Shamoon. The key clue in your case is that Rando-M RD (ranitidine with domperidone) relieves the nausea but it returns the moment you stop it. That tells me the acid and delayed stomach emptying are being suppressed, but the underlying cause has not been treated. At 22, with persistent nausea, no vomiting at all, and reduced appetite, the most likely diagnoses are acid-related: gastritis or acid peptic disease, GERD, functional dyspepsia, or H. pylori infection - H. pylori is very common in India and is the classic reason acid symptoms keep relapsing after every course of medicine. Delayed gastric emptying (gastroparesis-like functional problem), gallstones or gallbladder dysfunction, and worm infestation are also worth considering. Two non-stomach causes I would not miss at your age: anxiety and stress, which cause genuine physical nausea and appetite loss, and habits such as skipping breakfast, late-night eating, excess tea/coffee, smoking, alcohol, or regular painkillers - all of which directly inflame the stomach lining. Please also note that ranitidine is a weak, older acid suppressant and has largely been replaced; a proton pump inhibitor such as pantoprazole taken 30 minutes before breakfast controls acid far better, and domperidone should not be taken continuously for long periods. Since your symptoms keep coming back, the right approach now is to establish the cause with tests rather than repeat symptomatic tablets.
Next Steps
1) Get these tests: H. pylori stool antigen or urea breath test (not the blood antibody test), CBC,
LFT with SGPT/SGOT and bilirubin, amylase/lipase,
thyroid profile, fasting
sugar, and an ultrasound of the abdomen for gallstones. Stool routine for ova/cysts is also worth doing. 2) See a physician or gastroenterologist in person - if H. pylori is positive, a 14-day combination course (2 antibiotics plus a PPI) usually gives lasting relief instead of temporary control. If symptoms continue despite that, an upper GI endoscopy is the definitive next step. 3) Do not keep restarting Rando-M RD on your own; long-term domperidone is not advisable. Discuss switching to a PPI taken 30 minutes before breakfast for 4-6 weeks under supervision. 4) Diet: eat small meals every 3-4 hours, never skip breakfast, finish dinner at least 2-3 hours before lying down, and avoid excess tea/coffee, aerated drinks, fried and very spicy food, and citrus on an empty stomach. Curd, bananas, coconut water and plain rice-based meals are usually well tolerated. 5) Stop smoking, alcohol, tobacco/gutkha and any over-the-counter painkillers if you use them. 6) Keep a 2-week diary of nausea timing against meals, sleep and stress - the pattern often reveals the diagnosis. 7) Weigh yourself now and recheck in 2 weeks; report any weight loss to your doctor. You are welcome to consult me on Practo to review your reports and plan treatment, or in person at Synergy Multispeciality Hospital, Miraj.
Health Tips
Word of caution: see a doctor promptly if you develop vomiting of blood or coffee-coloured material, black tarry stools, severe or persistent abdominal pain, difficulty swallowing, unexplained weight loss, yellowing of the eyes, fever, or if you become unable to keep fluids down. Do not take domperidone continuously for months or take acid tablets indefinitely without a diagnosis - masking symptoms can delay detection of a treatable cause.