I have been suffering from GERD for approximately 10 years. My symptoms have been persistent and significantly affect my daily life. I experience severe heartburn and a constant sensation of breathlessness, even with minimal physical activity such as walking or slight body movements. The breathing difficulty is one of my most concerning symptoms. I did endoscopy 4 times so far , did 24h ph test and esophageal Manometry as well my demeester score is 17 and Acid exposure time is 4.2% and Manometry is normal I have tried multiple treatments over the years, including (PPIs, PCABs), and low-dose amitriptyline, but none have provided lasting or significant relief. Despite ongoing treatment, my symptoms continue to worsen or remain unchanged, and my quality of life is severely impacted. I would like to understand whether surgical options such as anti-reflux surgery could be effective in my case, and what evaluations or tests would be required to determine if I am a suitable candidate.