If you have been suffering from GERD for many years, but have been on PPI's, no matter what your symptoms you may very well show a perfectly healthy esophagus. (That's what happened to me. I've had 3 and none have come out bad. The one time I could guarantee that the doc would see esophagitis was when I was hospitalized for asthma that was caused by GERD. At that time an endoscopy was the very LAST thing I wanted, as I feared it would irritate my esophagus further and make my recovery that much more difficult.)
The value of an endoscopy is that it will show whether there is a problem there, and can if the LES is open a bit or closed tightly. (If you're having intermittent problems, that could be random, though.)
I would not recommend that you not try to get bad things going for yourself. It's just not worth it. Write your GERD history, symptoms, frequency, triggers, length of flare ups, things you're doing proactively to stop the problem (ie. elevated bed or wedge, avoiding GERD triggers, not going to bed after eating, etc.) Be assertive and share how frustrating your GERD problems are and how debilitating at times.
That way you can check to see if all is well in your esophagus (always a worry for those of us with GERD) but will be armed with a very convincing case for why you need help.
If a Nissen surgery is in your future, having esophagitis when you're getting scoped isn't a prerequisite. There are a lot of factors involved in that decision. It may take a while, but if you need it, it'll happen. I waited four long years of poor health before my GI doc finally sent me to a surgeon.
Patience, accompanied by Perseverence will be required. Don't give up, but let it unfold. That said, be assertive and advocate for yourself.
Hang in there, Ashley. We're with you!
Post Edited (dencha) : 9/3/2011 1:08:35 PM (GMT-6)