I have been taking ppi for years. i was 23 when i started, and now im 29. this particular ppi is starting to not be effective. surgery time? or change medicine? i tried getting off, but cant even w/ healthy eating. long term decades safe?

Would follow up with gastroenterologist and undergo and endoscopy to assess why you need PPIs. Do you have concomitant H.pylori a bacteria that is associated with ulcers and needs antibiotic therapy?Ulcer? Do you have food intolerances or eosinophilic esophagitis? Bile reflux? F/u/ w/ gastroenterology

PPI's are relatively safe, but long term side effects have been increasingly described. Serial upper endoscopies are used in case symptoms become refractory. Weight loss always helps if overweight and having reflux symptoms. Rebound acidity is typical when trying to discontinue PPI's. Your gastroenterologist remains your best reference at this point.

Why do you need PPI? Do you have H pylori infection? If so, it can be treated. Do you have hiatal hernia? It can be repaired. If you acid reflux you may need to lose weight to reduce intra-abdominal pressure. It is not feasible to provide a meaningful opinion without additional history, physical examination and may be some tests. It would be prudent to see a doctor, preferably a GI specialist.