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

### input:
Fluttering in abdomen just below center of rib cage. I can feel it all the way up my throat . When it flutters it feels like it is hard to take a breath. I am 32 male. I have Gastritis and Doudenitis. Had a hida scan with a 61% ejection fraction . I am burping alot. Ate homemade pizza then a banana then it started. Went to the ER and sent me home still with the problem. It is worse laying flat.

### output:

Hello, kibbeylester, You state that you have been diagnosed with gastritis and duodenitis. I am assuming this was after you had endoscopy and biopsy. Hope you were also tested for H. Pylori which is very common with the above conditions. The biopsy would show this and also there is a breath test to diagnose this. I am also assuming that you were prescribed a PPI of some sort (Proton Pump Inhibitor) like Omeprazole, Lansoprazole, Rabeprazole or Omeprazole etc. Getting HERD symptoms after eating Pizza is almost like test for reflux ! Cheese contains calcium, and it can stimulate more acid production. Tomato sauce (Tomato products), caffeine in coffee and tea, alcohol, citrus Chat Doctor. I am sure you probably have some inflammation of the lower esophagus at the junction of the stomach. Laying flat makes it easy for the acid to travel back up into your esophagus because of the weak sphincter muscle. If you do take the PPI, make sure you take it about an hour before you eat, twice a day for 4-6 weeks or even longer if needed till you are symptom free. I wish you well.