I've been on Protonix for several years, recently my dosage was upped to two 40 mg. I have nighttime reflux, never any symptoms during the day. All lifestyle changes made, bed elevation, not eating after 6:00pm, etc. etc. My doctor, whom I consider an able physician, has repeatedly assured me of the safety of the PPI class of drugs. Even said her 9 year old daughter was on Protonix. After learning of the latest warnings of these drugs, increased risk of fractures, inablility to fight certain types of bacteria, etc., I really wanted to go off of this drug. I have not been able to do so, as the pain interrupts my sleep and with fragmented sleep I am a zombie the next day. Is there a "step down" treatment available? Is the Esophyx procedure successful in those experiencing nighttime GERD ( I believe NERD - nonerosive, as I have had three endoscopies in the last 5 years and they have all shown no evidence of erosion in the esophagus. With these dire warnings about PPI's, what are doctors now telling their patients, if anything? What is the current medical wisdom and advice? I anxiously await the answer of an expert.