Only your healthcare provider can help diagnose and treat YOUR situation, so keep working with them on this.
But what I can do is help reflect your own statements back to you.
Regarding the recommendations that your doctor gave you:
(1) You say you're not responding to weight loss - but that you are still 40 lbs overweight.
You have reduced your ...
I would first and foremost attempt to lose weight; nevertheless, Endoscopy is not really the the optimal test to diagnose hiatal hernia. You should do a double-contrast Esophagus-Stomach-Duodenal X-Ray.
As for what Gene said re: PPIs, it makes no sense. Their mechanism of action is to inhibit the chemical mechanism that allows the gastric parietal cells to ...