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I have gerd and also suffered from terrible heartburn! Had endoscopy that showed inflammation in my esophagus. I was put on prontix which helped but didn't stop heart burn completely, then MD switch me to nexium 40mg which was better than the protonix but (like you) it didn't last 24 hours. Finally my heartburn was controlled by taking 30mg of prevacid TWICE daily (one 30mg prevacid in the a.m and another 30mg prevacid at p.m.). I've had some constipation, but the heartburn is gone. Don't know if thepevacide caused the constipation, but strongly suspect it. I now also take metamucil. You might ask if you can take nexium twice a day (don't know if that's possible) or try prevacid twice daily. If you have bad reflux like me, it may be the only solution. I've also avoided fatty, fried, spicy foods, but I still need the PPI twice daily!