### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been having severe upper abdominal pain penetrating to my back. The pain only sets in after bedtime and is unbearable until morning when it gradually subsides. Needless to say, sleep is not a possibility. I have had an endoscopy (acute acid reflux), an HIDA test and ultrasound for gall bladder (no stones were detected, gall bladder, pancreas and liver appeared normal. The pain lasts for several nights and then I have no symptoms for 2 - 3 months. I m having an attack again now and in serious pain. Any thoughts on how to get any relief?

### output:

Hi! Good evening. I am Chat Doctor answering your query. The pain could be due to the acid reflux, as other factors were excluded by the investigations as noted by you. If I were your doctor, I would advise you for the following:1) Elevate the head end of the bed with two blocks on each side, so that the regurgitation does not occur while lying down, and the contents of esophagus and stomach flow down with gravity.2) Some modification in your diet like more of roughage, enough liquids, avoidance of oily, fried, and fast food, and avoidance of alcoholic beverages and smoking if you do.3) Regular routine exercises like morning walk depending on your medical fitness.4) Prescription for a prokinetic agent and a proton pump inhibitor for symptomatic relief and to have a control on the acid production and facilitate movement of gastric contents downwards. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing Chat Doctor to clear doubts on your health problems. I wish you an early recovery. Chat Doctor