I know this thread is old, but wanted to share my experience, in the hopes you are smarter than I and never let things progress as long as I did! I started dealing with GERD throughout my pregnancies. (Oldest DS is 17) It got so bad by the third one that I was vomiting on fairly frequent basis, which continued for the next 7 years.
In retrospect, that sounds ridiculous to let it go so long, but I just figured it was something I needed to work around. I knew all the stuff about elevating the head of the bed, avoiding spicy/highly acidic foods, caffinated beverages, ETOH, etc. and usually was able to keep some contol over symptoms. But, I always kept a plastic bag in my truck for "emergencies", and tried to keep crackers available for quick acid absorption. (My poor DH has high gag reflex and low tolerance for aftermath of vomiting episodes - was getting really frustrated w/ situation)
I was on Ranitidine for years, and then an insurance/pharmacy (mail-order) change sent me something else - can't even remember what. It did not work for me at all, and I began vomiting on almost a daily basis. This was the final straw for DH who said I shouldn't have to live like this. I had seen a GI guy once for a scope, no obvious anatomical malformations, etc. so keep up w/ meds, food restrictions, blah, blah.
When sx increased, PHP first got me Rx that worked, then sent back to GI specialist. The GI found Barret's esopogus (pre-cancerous cells), and that I also had a hiatal hernia. I was then referred to an surgeon.
I ended up having a Nissen fundoplication, and my hiatal hernia was a quarter of my stomach in my chest cavity (!)
Happily, I have been medication and emesis free for more than two years post surgery, although if I overeat, or eat too much spicy/acidic or other inflammatory foods or beverages I can still get heart-burn. (But, I feel that it is w/in levels of what would happen to anyone!) And, thankfully, Tums/Rolaids takes care of it now.
Anyway, all that to say - don't accept that there is nothing more that can be done. There could be serious damage being done by the acid that is in the wrong place. (And which also causes pain - I cannot describe the pain of stomach acid that refluxes high enough to get into eustachian tubes in the middle of the night. That'll wake ya up!) And, that damage may be worsening whether you feel it or not. Hope you have found something that is working for you!