I have serious acid reflux. i have tried every ppi and over-the-counter med. i am on carafate (sucralfate) currently. i avoid all the bad acidic foods. no relief?

PH or Impedance Imp.: PPIs are progressively less effective for heartburn, regurgitation, and extra-esophageal symptoms. Reflux can continue to cause symptoms despite PPI therapy because of persistent acid reflux or weakly acidic reflux. pH or pH-impedance monitoring becomes essential. . Antireflux surgery is an alternative in patients if a clear relationship is established between persistent symptoms and reflux.