1.

Name:Sowmya

2. Age:29

3. Sex:Femal

4. Height: 5 feet

5. Weight:59

6. Citizenship: India

7. Occupation: Software engineer

8. Type of Food, (Vegetarian/Non-vegetarian ): Vegeterian

9. Digestive Power (Good, Satisfactory, Bad) : Bad

10. Bowel habit (Frequency, Consistency): everyday once

11. Sleep (Deep, Disturbed): disturbed

12. What are the main symptoms? Burping after eating burning sensation in
stomach, Constipated , acid reflux, throat burning, GERD

13. Is the disease identified? If yes, Please name it: GERD, GASTRITIS and
Grade A reflux Esophagitis.
14. When this problem first started? Been an year

15. Is there a known reason?

16. Is it recurrent in nature? Yes

17. What is the present treatment being undertaken? None took PPI
allopathy but did not see much improvement

18. What were the previous treatments taken and what were their success
rates? Allopathic nothing great

19. Are there some other chronic or diseases present? None

20. Which are the medications now used to control those diseases?

None

21. Whether your hand, leg or other joint movements / daily activities are affected due
to this? None

22. Is there any problem with control over urine or bowel (incontinence)?

Bowel incontinenece

23. Is there any cardiac involvement?

None

24. Is there any specific issue to be informed (allergies, High BP, High Sugar, High
Cholesterol, Suppressed sensory activities etc..)?None

25. Any addictions (Smoking, Drinking, Drugs) None

26. Do you have any communicable diseases (HIV/ TB/ Hepatitis/ Herpes etc. . ) None
27. Please attach the relevant reports such as X ray/ MRI/ Blood test reports.