1) Stop ranitidine. A doctor will usually start a PPI such as pantoprazole 40 mg once daily 30 minutes before breakfast for 2-4 weeks, and may add a prokinetic (domperidone/levosulpiride) before meals for the bloating and nausea. 2) Get an H. pylori stool antigen or urea breath test — in a 28-year-old with 1 week of meal-related nausea and fullness this is the single most useful test, and it must be done before starting the PPI or after stopping it for 2 weeks. 3) Get an ultrasound of the abdomen (gallstones, fatty liver), CBC, serum amylase/lipase, thyroid profile and a fasting blood sugar. 4) Diet: small frequent meals, avoid fried/oily food, carbonated drinks, excess tea/coffee, alcohol and smoking; do not lie down for 2-3 hours after eating; raise the head end of the bed. As an IT professional, sitting for long hours right after lunch makes this worse — take a 10-minute walk after meals. 5) If symptoms persist beyond 4 weeks of proper treatment, an upper GI endoscopy is the next step. 6) You can consult me on Practo and share your reports for a detailed review and a proper prescription plan, or if you are near Miraj/Sangli, visit me at Synergy Multispeciality Hospital, Miraj, for an examination with ultrasound the same visit.

Word of caution: seek urgent care if you develop persistent vomiting with inability to keep fluids down, vomit that looks like coffee grounds or has blood, black tarry stools, severe or constant upper abdominal pain, fever with jaundice (yellow eyes/urine), unintentional weight loss or difficulty swallowing. Please avoid painkillers like ibuprofen/diclofenac and alcohol until this settles, and do not continue medicines like ranitidine bought over the counter.

feel free to consult me on practo for further evaluation and management

eat small quantities of food frequently rather than large meals