How much time for an acid reflux disease medication *not* to work before a gastroenterologist considers surgery?

Failed maximum Rx?: There are lots of "non-invasive" anti-reflux procedures -- some performed endoscopically and others by surgery. Most cause some permanent change at the level of the LES, and none are complication-free. Most are relatively new, so there is limited data to prove long-term benefit. First see a gastroenterologist to better document why & what you are refluxing (consider pH impedance testing, more).