If you've had success with PPIs for 20 years, it seems as if you needed them. Generally we aren't provided with PPIs by our doctors unless there is very good reason. It's not likely that your GERD has improved over that time. If you're anything like me, it has progressed, and is worse than it was when you started on PPIs. It's a fact of life that as we age, things stop working as well. Boo hoo.
Actually, noone should have surgery before having the following tests:
Manometry (I know it's tough, but you can do it!)
24 hr PH monitor
Stomach Emptying (in your case this would be important, because if that's the issue that's causing your burping, it would be critical to know.)
Your belching could be a reaction to a very loose LES, which allows gas (and acid) to escape at will.
I assume you're seeing a GI doctor. Believe me, most GI docs will not recommend a Nissen surgery unless they think it's absolutely necessary. Just be aware that it is one of the options available.
Have you tried Zantac in addition to your PPI experiments? Don't take them at the same time, but it might be helpful in the interim. Ask your doctor. Be sure that you're taking the PPI an hour before eating and make sure that the first meal you have after your PPI is high in protein, which helps it to work.
Glad you've joined us.
Nissen Fundoplication 2/09
"Whatever you fight, you strengthen, and what you resist, persists.”
“Worry pretends to be necessary but serves no useful purpose”
“Accept - then act. Whatever the present moment contains, accept it as if you had chosen it. Always work with it, not against it.”Eckhart Tolle