Welcome to Healing Well! So sorry to hear you're having so many problems. I think it is quite common that one PPI starts being less effective. You might get your doc to prescribe a different one, and see if that does the trick.
I started on Prilosec, went to Nexium, and lastly, Protonix. I also had the surgery for GERD (Nissen Fundoplication) and it has improved my health tremendously. While there is no guarantee that you will never need another PPI after surgery, many do not, while some need much less than they took before the surgery.
Here is a link with some information:www.mayoclinic.org/gerd/treatment.html
I had severe asthma caused by GERD for about
four years before I finally had the courage to have the surgery. I am so glad I did. Is it a perfect fix? No. Is it 100% better than before? Yes. I still have asthma caused by allergy, but now it is not made worse by GERD, and I am free of asthma in the winter months when the pollen is quiet.
It sounds as if you have typical GERD symptoms, so the surgery would work great for you. I would caution you (as Joe so wisely did) that you need to find a highly skilled (in this particular surgery) surgeon who has done 300+ to 1000+ of these procedures and is extremely skilled. It's not enough to find a good surgeon. You need to find a great NISSEN surgeon. There's a big difference. In my city (where we recently moved) there is one surgeon that all the docs send people to. He's the one who (as they say) "does all the Nissens". That's the type of doc you need.
Also...some people are successful combining PPIs and H2blockers (Zantac). You can use OTC Zantac, or ask your doc to consider trying you on some. Many people take 40mg PPI plus 300mg Ranitidine (Zantac) at bedtime.
At times people can have GERD flare-ups when they get into some gastritis. Perhaps your stomach is irritated, and thus producing more acid than usual.
Just a thought.
Good luck finding an answer!