Nexium (esomeprazole) bid + zantac bid = still have reflux. no spicy food, seems like eating anything, or taking pills triggers. what could that be?

Recalcitrant reflux: It sounds like you are having recalcitrant reflux, which means that you are still symptomatic in the face of maximal (and appropriate) medical therapy. The the thing to do is see your GI and undergo extensive testing- endoscopy, esophagus studies, ph studies. It is not normal to have such persistent reflux and can be dangerous to your tissues.

Nissen fundoplicatio: Perhaps you need to discuss surgical options with your doctor. If bod therapy is not working, then a surgical correction of your reflux may be indicated. The medication is strong and such work. The surgical option is minimally invasive and has durable results for decades.