Hi. Thanks for your query. Noted the history and understood the concerns. Since you are a known patient of acid reflux and IBS, it is necessary to see why the medicines have failed to relieve of your symptoms. I would advise you the following: To get a review by the Medical or surgical Gastroenterologist. Upper GI Endoscopy. Colonoscopy as you have IBS hence to rule out any organic pathology. Contrast enhanced CT scan of the abdomen. Manometry studies of esophagus and stomach to see the pressure gradients whether normal or high. Basic investigation of Barium swallow and follow through under fluoroscopy control to see the exact peristaltic movement of the esophagus an to see any motility disorder is the best one yet. Continue the medications as before . Get added on Domperidone or Metoclopramide as motility regulator. Small frequent diet of soft and bland things. In your case the role of anxiety and stress must be high hence you have to control it by any means possible, get medicines if required, helps a lot. Sleep in reclining position., For IBS too control of stress and anxiety is the basis of management.