Hi,
Thanks for posting your query.
With the available described symptoms, there appears to be possibility of peptic ulcer disease associated with decreased gastrointestinal motility.
You should consult with internal medicine specialist/ gastroenterologist and should go for thorough check up.
You should also go for complete blood count, blood sugar both fasting and postprandial, thyroid profile, serum electrolytes and endoscopy & biopsy.
You should also go for urea breathe test for Helicobacter pylori bacteria.
You should take proton pump inhibitors along with prokinetics and antacids for relief of your symptoms.
You should avoid tomatoes, citrus fruits and oily spicy foods.
Take care,
Dr. Mayank Bhargava

Hello!

Thank you for the query.

First of all you should get proper diagnostics. Your symptoms can be triggered by Helicobacter Pylori infection what should be verified and treated with antibiotics if the infection is present.
As you do have severe gerd symptoms, you need to have endoscopy performed every few years as such chronic increased acid secretion leads to stomach inflammation, stomach metaplasia and dysplasia (which is early stage of stomach cancer).

I suggest you to visit gastroenterologist and get scheduled for upper GI endoscopy.
In a meanwhile you should avoid coffee, chocolate, fatty foods, soft drinks, fruit juices. Last meal should be 2 hours before sleeping.

Hope this will help.
Regards.

Hello, Michelrstone01,
You mention that you have had GERD symptoms for a number of years.
I am assuming that you have had a good endoscopic evaluation done
by a gastroenterologist. You also said, Nexium did work for a while and
stopped being effective. This can happen with any of the PPIs (Proton Pump
Inhibitors) although failure is more common with H-2 blockers such as Zantac
& Tagamet.
The reasons for failure are multiple.
One, is the timing. You should take the drug about an hour to hour and a half
before your main meals even if you take it twice a day.
Second, you should watch your diet. Avoid alcohol, excess caffeine, dairy products,
tomato based products, pain killers like aspirin, ibuprofen, naproxen etc.
You should not go to bed within two hours after your evening meal.
If your endoscopy was many years ago , you do need a re-evaluation at this time.
The doctor can look for any complications such as ulcers or erosions, narrowing by
scar tissue etc. He can also do a biopsy to look for H.Pylori bacteria that causes
persistent symptoms. If positive , you need treatment for that.
Sometimes, switching to a different PPI may be helpful.
I hope , now that you have enugh information, you can discuss these with your
own doctor who can guide you properly.
I wish you well.

Hello,
Thanks for posting your question.
You are having GERD For many years and now treatment is not working. Most GERD can be controlled through medications. In situations where medications are not working or you wish to avoid long term medication use, your doctor may recommend surgery.
Please visit your doctor and he may advise endoscopy and suggest invasive options.
I advise you to avoid smoking and lose weight if you are fatty. Use extra pillows to raise head during sleep. Take small and frequent meals rather than filling the stomach heavily.

Hope it helps.
Take Care!