Dave,I am sorry to hear you are still dealing with pain and I understand why you are not sure if you have GERD or Costo - or dang it, perhaps both.
I direct linked your info that you posted above regarding PPIs. That is a good article.
The reason that heartburn triggered by food is more discussed than heartburn on an empty stomach is because food is the most common trigger in most people. As you might expect, controlling the types of food we eat and how much of it we consume can do much to help control heartburn. Heartburn on an empty stomach isn’t really much different, except that food isn’t the trigger; a lack of food is the trigger. In simple terms, when stomach acid has nothing to “do” it can become concentrated. Some people report that heartburn on an empty stomach is worse than the heartburn they feel when they’ve eaten an offending food because the acid is very concentrated on an empty stomach.
GERD is not the only cause of heartburn on an empty stomach. Another condition that may cause symptoms that feel like those associated with GERD is a peptic ulcer. Peptic ulcers are small holes in the protective lining inside the stomach and are caused by the acids themselves.
The H pylori bacterium is the most common link in people with peptic ulcers. Medical experts believe this to be the reason that the stomach lining becomes vulnerable to the effects of acids. This is just FYI and remember I am not a Dr. I do not diagnosis but am simply sharing info with you.
I hear you on taking so many pills - I take a fair amount myself and sometimes I wonder which one is working or if they are all just working against one another. Grrrrrr.
Keep on posting as your thread has so much great info that is helpful to people experiencing what you are going through.
kindly,
Kitt