It could also be that your LES becomes increasing ineffective over those years, thus your need for PPI dosage increases.
I was on 40mg Protonix twice a day, and most of the time it worked just fine. My problem was silent GERD creating havoc with my lungs. I could have lived with a little breakthrough heartburn from time to time if it weren't for my asthma.
I have heard/read that many people do just fine on PPI's indefinitely, but there is a small subset of patients whose problems aren't solved by them. Obviously, I was one of those, and it sounds like you may be, too.
I had the surgery in February 2009, and while it caused changes in my upper GI tract, I gladly embraced those changes and as I call the, "quirks", for relief from the severe reflux episodes and lung issues.
After a couple months of post op severe coughing, before my lungs healed, I had about a year and a half of healthy lungs. (Post surgery, my lungs were very sick indeed, and no amount of steroid made them better.)
Unfortunately, all that coughing apparently damaged my newly formed, healing wrap (along with a very bad cold about a year later, that finished the job), because I'm afraid I may be a candidate for revision surgery (redo). That said, I'm still very glad I had the surgery, and will happily have the redo, as my lungs need protection.
The surgery isn't nearly as horrible as many have screamed on the internet. Yes, it causes changes in how things work, but it is certainly preferable to severe reflux. I would never recommend it for someone whose reflux is controlled by meds, but for those of us who find PPI's ineffective, and have severe issues caused by reflux, it is a godsend. It is "the gold standard in reflux prevention".
Anyone considering the surgery needs to research surgeons thoroughly, and find one who is extremely experienced and skilled in the fundoplication surgery. Many problems can be avoided by the choice of an excellent surgeon.
Good luck finding an answer to your problems. I feel your frustration. We've all been there! I struggled against the idea of having the surgery for four long years of lung sickness, and finally decided I didn't have a choice but to try it.
Secondary symptoms like asthma are not a sure thing when having the surgery. One never knows if that's the real cause of the problem, so it's even more of a "crap shoot". However I'd tried everything else that my docs could think of and still had horrible asthma, so I finally came to the decision that I had no other choice but to try it. If it didn't help my lungs, at least it could be ruled out as a cause and my docs could look elsewhere. Thankfully, it was the answer, and unfortunately, I compromised the result by waiting too long to act.
Take care and hang in there. You're in the right place. Many here have experienced what you're going through. I'm sure others will be by soon to offer their ideas.
Hello. You spoke of changes in your upper GI tract after surgery. Can you tell me what you mean by that? You also mentioned changes in how things work. I may have to do this surgery and would like to know what these changes are. Thanks