A 24-hr pH study can be considered to ensure there isn't residual reflux. An upper endoscopy also can be done to exclude anatomical causes or strictures that may lead to the symptoms. This can also look for ulcers or inflammation of the upper digestive tract.
If negative, you can also consider an abdominal ultrasound to exclude liver or gallbladder causes.
These options can be discussed with a gastroenterologist, or a second opinion can be obtained at a major academic medical center.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
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