People don't realize PPIs are a short term solution. PPIs are terrible long term. That being said, I'd be long dead without them. They are truly a life saver until you find out the root cause. Many trips to the ER and years later, I found out avoiding gluten and taking probiotics cured mine.
Some people (like myself) suffer from functional dyspepsia, in which GERD-like symptoms are observed with no apparent cause. There's really no standard treatment: some people find relief from PPI's, H2 blockers, small doses of SSRI antidepressants, or changes in diet. Every doctor I've talked to (including one of the top gastric neurologists in the country) agrees that, given a choice between taking PPI's long-term or suffering from functional dyspepsia, they'd take the former every time.
Indeed, I was on PPIs for years. Before them, I used to wake up choking on bile, I was eating tums like candy. Then I changed my diet and starting taking baking soda in water of all things. When travelling I'll go back on PPIs for the trip, and notice a distinct feeling of unwellness. But I simply don't want to deal with questions of the form; 'what's this white powder in your luggage?' so I deal with it.
I've had to make my peace with just having to hit a store on the other side of the trip. Fortunately, baking soda is cheap enough that you don't have to mind throwing it away.
You could also conceivably make your own pills, which at least in my experience nobody will question: https://www.amazon.com/Cap-M-Quik-Tamper-Capsule-Filling-Mac... (I don't make my own pills, but I've carried around a variety of pills that look like they were made that way.) But for baking soda that's probably a little elaborate, plus I don't know what happens if you take baking soda that way rather than in water.
Same story here. Aspirating bile is the worst, that awful soap taste, the burning when breathing.
For me, cutting gluten and fried foods out of my diet entirely minimized my stomach woes. The gluten thing came about after I was tested for antibodies when my son was diagnosed with type 1 diabetes. So, lucky, not lucky I guess.
