No relief no matter what

[DDuck126]

I am 47, female, with history of heart disease and diabetes Type II. Have had acid reflux for a couple years, controlled fairly effectively with protonix. However, for the past 9 months it's gotten severe, daily, and symptoms are after I eat something, worse in evenings. Have had H-pylori, upper GI, endoscopy--nothing significant. Ultrasound of thyroid too. Nothing works, have tried omeprazole, famotidine, reglan, antacids, ranitidine, and others. My lower throat feels like it cramps and I can't breathe, then the blood and oxygen rushing to deal with that makes my heart start pounding. I am wondering: is there anything I can suggest to my doctors to look at next, or another drug I can try since the only thing that gives me relief is sublingual nitroglycerin and I go through 100 of those a month ? Thanks for ANY suggestions, I am desperate.

[Ratnakar Kini]

Hi,
If you are not responding to one type of PPI switch to another.
If you do not respond to once daily dose take it twice daily.
Take them empty stomach.
If still you are not responding reevaluation is needed and 24 hours pH monitoring test may be done for confirmation. Sometimes it could be due to bile reflux and the treatment is different.
If acid reflux is confirmed and not responding to medical therapy then surgery might have to be done.
I would also suggest that esophageal manometry be done to rule out esophageal spasms which can cause similar symptoms.

[DDuck126]

Forgot to mention, I am on 300mg ranitidine twice a day and avoiding all the foods and drinks all the research indicates. Still have breakthough symptoms, severe and frequent, any time there is food in my system.