I have had symptoms of silent reflux for 5 months now and finally did a 24-hour esophageal pH monitor that confirmed I have reflux.
I'm in my 30s, I am 40 lbs overweight (which I know is bad, but I'm not "can't-get-off-the-couch" overweight) and I am not responding to any PPIs (my GI has tried me on omeprazole, nexium and dexilant).
Prior to doing the pH monitor, I had an endoscopy that revealed:
- 3 nodules in my stomach that were biopsied and came back benign
- No hiatal hernia
I also had "manometry" done that showed some slight abnormalities with my swallowing, where the lower esophageal sphincter (LES) wasn't relaxing properly as the "bolus" (the thing being swallowed) passed through my esophagus.
My diet isn't perfect but is orders of magnitude better than it was 5 months ago, and I've lost 25 lbs so far (so yes, I used to be ~65lbs overweight). Very little chocolate, caffeine and alchohol. I don't smoke.
I finally had a sitdown with my GI where I asked her if she had any idea what is causing my reflux since I don't have hernia, I've lost weight, my diet is under control and, most importantly I'm not responding to the PPIs.
She simply said she didn't know. I asked her if there were any surgical options available to me and she said that I wouldn't qualify for surgery because I would need to show a response to the PPIs first.
Finally, my question
I feel like I'm in No Man's Land. I have confirmed reflux, but am not responding to any of the things that normally treat it. Are there any other known causes of GERD that may have been overlooked here?