I've been on 5 different PPIs, and if I included the different dosages, probably ~10 different prescript
ions. In each case, I found that the better PPI or higher dosage increased effectiveness for a few months, but then my body got used to it and no longer gave much improvement. So you could increase the amount or frequency of nexium you take, but I wonder if it will result in a permanent solution for the rest of your life, without having to change the dosage again and again and again.
I too had a hard time lifting weights and building muscle as a 20-something male. I would 'give it my all', lift weights 3 to 4 times a week, and listen to very upbeat music to try and motivate myself, but I began to see fewer and fewer improvements. As my own GERD got worse, I stopped lifting and had trouble eating >1,000-1,500 calories a day. I am 6 feet tall and went from 180 lbs to 145 lbs at some point (over a 1-2 year time frame). My struggle was then more about
maintaining any body weight (and not necessarily building muscle, which was already gone at that point).
As I struggled to maintain my weight, I began to notice that I could have certain very high calorie items that would not affect my heartburn at all. For instance, a large Oreo milkshake from Baskin Robbins has 1,500 calories, ~70g of fat, 180g of carbohydrates, and 32g of protein. Eating one of these doesn't seem to have any bearing on my GERD symptoms (maybe because it is liquified and easy for the stomach to digest?). I don't life weights anymore, but once or twice a week I will eat one of these in order to keep myself from losing weight. As long as this item doesn't bother you and you can afford spending the $6 every other day, it almost completely solves the problem. 1,500 calories added to your diet is really a lot.
While the 180g of carbs may sound way too high, I also am finding that different sugars affect me differently. I can tolerate items with more glucose than fructose (or if the sugar is sucrose), but not the other way around. For instance, if I went to a smoothie place and got a fruit smoothie with a few 'shots' of protein, it would give me bad reflux a few hours later (btw, many fruits like mangoes, apples, etc. tend to be very high in fructose). There is also science behind this - researchers are finding that items with more fructose than glucose may contribute to digestive problems like IBS, GERD, etc. Apparently, if there is too much fructose in the intestines (relative to glucose) it can spark a bacterial overgrowth and produce excessive gas. This excessive gas can increase pressure in both directions of the digestive tract or can impede movement of food through the body. Onions and garlic have 'oligofructose' (chains of fructose sugars) which are apparently one of the worst things you can have if you are sensitive to fructose. You can find out more about
this by searching for 'FODMAP diet' and related research articles.
I think these types of high calorie items are much easier on the digestive system compared to steak, chicken, peanut butter, etc. with the same amount of calories. I also blend my own veggies (carrots, kale, spinach, almond milk) with protein powder. Doing things like this has increased my weight to 160 lbs.
Thus, maybe it's just a matter of finding out which high calorie items are better for digestion. Perhaps it's unlikely that the fructose issue pertains to you at all, but I'm just trying to emphasize that you'll probably benefit from understanding was kinds of 'small molecules' your food is made of and trying to identify a link through an elimination diet. If you could figure this out, you may not be as calorie restricted as you are now.
Post Edited (EJohn) : 6/24/2017 1:28:20 PM (GMT-6)