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   I have been taking Nexium for many years, and Prilosec previous to that, after having been diagnosed with GERD due to a "large hiatal hernia".    I later moved to another state. At one point, after an endoscopy and colonoscopy, my gastroenterologist told me that he saw no evidence of the "large hiatal hernia". How can this be, when the diagnosis was so positive about five years before that? Can he have make a mistake?    He advised me to take double the usual dose of Nexium, upped to 40 mg TWICE a day, and told me I would probably have to take it for life. As long as he was able to provide me with samples, that worked just fine in controlling the problem.    Eventually he moved his office too far away for me to continue getting the samples and my insurance refused to pay for the Nexium, which is extremely expensive. No other medication seems to give me as much relief. So I continued on the Nexium at great expense, but have had to keep my dose to 40 mg ONCE a day.    Another five years later I now find myself suffering from the addition of the following symptoms...       1) frequent coughing up of gooey phlegm, in particular when it wakes me up during the night or immediately after eating a meal, and       2) mostly recently, the addition of bile backwash into my mouth, a very foul taste. I am continually chewing gum and anything I can to relieve that horrible taste (and odor).    Since I am now dealing with a host of other serious health problems (i.e. breast cancer, pulmonary emboli, polymycitis, and sleep apnea), I hesitate to go to another gastroenterologist for more testing. I have had to add Warfarin and Prednisone to my list of meds and wonder if that total combination could be causing the additional gastric problems. I was recently prescribed a CPAP machine.    I hate that I have to go to so many DIFFERENT specialists and they do not get together to coordinate my treatment, thereby understanding how my system functions as a whole and not per individual organs or maladies.    Your advice is more than welcome........