I take my first dose of PPI first thing in the morning with at least a glass of water and an hour before I eat. I take my last dose at least an hour before bed and at least 3 hours after my last meal.
I don’t feel heartburn that often but I do have what feels like esophageal spasms sometimes due to acid and the hernia also seems to cause some of my dysphasia… weirdly enough, being on my right side elevated by a wedge pillow and raised bed seems to provide optimal swallowing of my saliva as I am in bed at night and makes the pressure in my chest feel less tight possibly… possibly indicating the hernia is to blame for in large part for my dysphasia that is variable throughout the hours, days, weeks, and months.

I try to avoid anything that might be a trigger food even though I don’t really feel heartburn or reflux that often but sometimes I taste the acid in my mouth, or some kind of non-acidic weird taste on such high doses of PPI.

I think, possibly due to chronic constipation, like my mom has, and the weight lifting and unloading trucks for most of my young adult life while going to university, and playing brass instruments from about 12 years old to 18 years old, really set me up for this.
Note: daily miralax use has rid me of my constipation so that is hopefully no longer an issue as far as abdominal pressure.
My mom has a hiatal hernia that seems to be fully or mostly asymptomatic so there is possibly some genetic component and I sped things along being so active.
I want to do as much pre-op testing as is needed to fill out anything else, but due to what I have experienced and had done already medically, I think the hiatal hernia is the issue.
I have a smaller body and frame so the 3cm hiatal could very well be the major issue.

This all being said, I think repair of the hernia, as many side effects as it can cause, my be my only chance to correct the issue and return to a somewhat, hopefully fully, normal life.

Edit: I am only 29 years old and have had these issues since I was 27, possibly a little before that. I have had a healthy body weight almost all my life… usually my weight gets too low if anything, especially since the dysphasia has kicked in.

Also, I meet with my GI doctor on May the 3rd to fax my information and hopefully get a referral. They already indicated surgery was probably an option, I just don’t want it at my local hospital and would like to get a better understanding of what is making my hernia grow and what is causing all my issues/what would be the best surgery for me and I think Mayo will have a bed chance of success than the place I am now.