I had real bad GERD for a couple of years before I had the laparoscopic Nissen fundoplication surgery (basically, they sort of recreate the lower esophageal sphincter muscle to help keep acid from coming up from your stomach). I took aciphex too, and for a while, it worked wonders! But, it did stop working as well, and I doubled the dosage, and it worked for a while, and then stopped working. That was when my doctor decided to send me to the surgeon to do an EGD to look at my esophagus and stomach. It turned out I had a lot of damage, and really needed to get the surgery to control the GERD. The surgery was last October, and I will happily tell you that it was worth it!! I feel so much better. I still take one aciphex a day, just to help keep my GERD in check, and since the surgery, I have only had one case of heartburn.