Burning tongue & bitter/metallic taste - meds no help.

Hi everyone. I've been a member of the GERD forum for a long time but I'm hoping more people here have had experience with burning tongue, or burning mouth syndrome (BMS).

Here's my story in a nutshell.
* 35 y/o male, 5'10, 150 lbs. Exercise 5 days a week, good physical shape. Good mental shape, or so I think.
* Around 2009, started having very tight throat, needing to swallow all the time. The only other symptom I had was on the rare occasion my throat wasn't tight, I would have a mild burn sensation on my tongue.
* 2011, finally went to the doctor and was diagnosed with GERD, which was surprising because I never have heartburn or regurgitation. I was prescribed a PPI (omeprazole), which improved my throat tightness by about 80% in 1-2 days. It was amazing relief.
* However when my throat tightness went away, I noticed an almost constant bitter taste in my mouth.
* I had various reflux tests and found I had a small hiatal hernia, and excessive weakly acidic reflux which was temporally associated with the bitter taste.
* about 8 months in to taking the PPI and having significant throat relief, I noticed more and more tongue burning along with the persistent bitter taste.
* Tried for "burning mouth syndrome": amitriptyline 25mg at night. Nothing. olanzapine 5mg at night. Nothing.
* I had Nissen fundoplication in January 2013.
* The Nissen has helped my throat. I am now off all acid blockers and my throat feels good, it was not this way before surgery so it was successful for that.
* However the burning tongue and bitter taste remain.
* I believe I may have had these tongue/taste symptoms for several years, but all the swallowing I was doing was keeping the taste away. If I mindfully swallow excessively now (say every 20 seconds), the taste and tongue irritation is decreased.
* I'm currently trying gabapentin 300mg a day (I know it's a low dose; I've also tried 900mg/day with no effect). It is not helping, either.

As a patient, I think it's unusual that I have burning mouth syndrome since it's mostly middle aged women. I also read about depression and anxiety, but I don't have those (and those are thought to make symptoms more bothersome, but not be the cause).

I'm mostly interested in finding out for people who have dealt with this, what kind of doctor is best to treat it? So far I've tried an ENT (when I was dealing with throat reflux) and my PCP. But they are not able to treat it with drugs. I'm wondering if an oral surgeon, a dentist, a neurologist might be able to take some scans or pictures and possibly SEE something that's mechanically responsible for this since these meds are of no help. Yet I do not see imaging mentioned in any of the literature on BMS.

Any ideas for treatment would be welcomed, thank you for reading.

I've taken various chemo meds and other's with a strong after-taste. My hematologist swears by Coke. Just plain old coke-not diet, flavored, or even Pepsi. Believe it or not, it does seem to work for me. It's not a total cure-all, but it differently makes a difference.

Hi White Beard. I see I left it out, but yes, I have been treated for candidiasis. My first visit to the ENT, the doctor did a through the nose scope and found lots of white gunk on the back of my tongue -- not visible from looking in my mouth. He put me on 21 days diflucan. No change in my symptoms, though the next scope his colleague did, the doc concluded that it didn't look like a budding infection anymore. That was in 2012.

In 2013 I've been back to my PCP about this burning, got loads of blood tests, the b12 was slightly high. The igE was slightly high (40 KU/L where normal is <25 KU/L), which I understand suggests some sort of allergy though my doctors said nothing of it. For now I am going to try toothpaste without sodium lauryl sulfate, and continuing to limit my diet. I've asked my PCP to see a specialist, and will see what she says..

Thank you for the suggestions.