GORD and LPR

Although I occasionally read these forums for help I try hard not to obsess about my health and rarely ever post. This time though I'm looking for an opportunity both to vent and to seek advice.

I developed reflux around 2000; it was pretty severe but kept in check by rabeprazole 20mg. Around 2004 I was offered a fundoplication (UK NHS) which had the immediate effect of relieving me of all symptoms. After three weeks or so I was completely recovered but, of course, was limited in the size of meals which was both expected and more than a fair trade off. After a few years the wrap presumably loosened and I ended up back on rabeprazole. This impacted on my health with both low B12 and low iron counts which I now counter by taking supplements. At the time of writing I'm generally feeling fitter and can do some light running.

Unfortunately, I've also developed LPR. I was prescribed 2 x 20mg of rabeprazole daily plus Gavison Advance after every meal for a period of 3 months about one year ago. I found that I couldn't tolerate the extra PPI medication but further lifestyle changes, not eating for 3 hours before sleep and raising the bed even higher allowed healing.

The LPR has since returned causing a sore throat and disturbed sleep. I'm honestly not sure what to do next. My local surgery has a couple of good GPs but the chances of seeing them are slight. The others quite clearly do not understand the condition (sent for an ultrasound to investigate whether the wrap was still intact) or, in one instance, is either out of date or disingenuous: I was told that rabeprazole was an 'old' drug and I should take omeprazole. This is the surgery's cheaper option, though not by much! Rabeprazole was, in fact, the last of the PPIs to be developed and studies indicate that it is better for long term maintenance of GORD.

So - what to do next? I'm obviously unsuited to higher doses of PPI, lifestyle changes are not enough and I'm concerned at the rate I'm consuming Gaviscon. Is there anyone out there who has had similar circumstances who might be able to offer any advice? I'm a 'keep it all in' sort of person but sometimes you have to put it out there and seek advice...

Thanks in advance.