<s>[INST] My elder brother is suffering from abdominal pain from last 25 years. In childhood frequency of pain once or twice in year. it was curable with hyoscine, metronidazole or ciproflxacin. From last two months he has continuous pain, heart burn . No relief with previous therapy. All sort of treatment (for ulcer , colitis ) have test given by doctors but no benefit. after extensive diagnosis of blood, urine, xrays, ultrasound, colonoscopy, now doctors are suspecting intestinal TB. treatment of TB has been started but still no satisfactory condition. Doctors are used to inject esomeprazole to lower acidity but it works for few hours only. Kindly suggest me the ways to follow [/INST] Hello, mna19bwp,You state that his problem has been present for over 25 years. Continuous pain and heartburn still indicates acid sensitivity. I am assuming he is still currently on oral PPI, since injectableEsomeprazole gave him some relief. He should be taking the medication twice a day, 20 mg twice about an hour before his big meals. I am sure he has been told to cut back on caffeine, alcohol,tobacco products, tomato based foods, avoid too much dairy to control the acidity. I am also assuming he has had an endoscopic examination of his esophagus and stomach with biopsy. He should have been tested and treated for H.pylori bacteria chichis responsible for duodenal ulcers and inflammation of the stomach lining, chronic gastritis. Intestinal TB typically affects the junction between the small and large bowel and can present itself as a lumping the right lower qua Chat Doctor. If all the investigations including blood tests were normal, other causes such as depression has to be considered. Hope they have done Celiac panel blood tests to rule that out. If your brother has had prior abdominal surgeries, chronic pain could be from adhesions or scar tissue and trapping of nerves. Sometimes, laparoscopy and exploring the inside of the abdominal organs may be necessary. Hope this gives you something to follow through. Wish your brother well. </s>