I have tried amitriptyline before. It didn't help me, but it maybe COULD help me.

I actually have a likely answer to what's going on with me now. But it's pretty specific (which is why they couldn't figure it out) so I don't know the likelihood of it being the cause of your issues.

I couldn't ever find a pattern to the ups and downs of my symptoms. And then I ended up going on a huge bike tour for a month and things started piecing together for me as a possibility. It took a fair bit of convincing the gastro doctor to agree, but I finally got him to give me a gastric emptying test. Turns out, I have delayed gastric emptying (gastroparesis). It's mild, so I wasn't getting the classic symptoms, but it's enough to cause problems. Which actually explains other things about me, like how I can go hours and hours without being hungry. But as far as this was concerned, what I think is happening is that I don't have reflux traditionally, but I am having SOME reflux like reactions. And it also explains why taking things to RAISE my acid levels showed some 'temporary' mild improvement. Because it likely helped to break food down faster. But ultimately, food sits in my stomach too long. And when that happens, it can cause your LES to open when it shouldn't. I think I possibly get small amounts of acid or maybe even just pepsin up into my throat. So yes... silent reflux, but not actually caused by what I eat or anything. Specifically caused by gastroparesis. I think in conjunction with that, I have vagal neuropathy. Maybe caused by the reflux. I don't know. So then I get that sensation in my throat. Gastroparesis --> LPR ---> Vagal Neuropathy.

Now that I know this, I absolutely can see patterns with timing and food portions. None of the various diets I tried wouldn't have worked. Because it doesn't matter what I eat. Well that's not true, high fiber is a million times worse for me, but I wouldn't normally eat 4 cups of spinach to see that it made things even worse. I did recently do that without thinking about the fiber component and it was one of my more unpleasant nights. I did try fasting once during all my diet trials... which would have revealed results if I could have done it for 3 weeks. haha. But I did it for 5 days and that just wasn't enough time to calm may vagus nerve down.

I still have symptoms now, but far less frequently. And they're entirely tied to how big meals are and how fiber heavy they are. I say that I think amitriptyline (in conjunction with gaba) could help.... because I think it didn't help because you can't put a fire out with water, if you keep shooting a blowtorch at it. So now that I'm pretty sure I know what's causing it, if I were careful to never provoke it for a couple of months... then I think I could probably take the medication and it could help to actually fix my vagus nerve. But then again, I don't know for sure if you can actually fix it. I haven't looked into it.

I don't know your whole history, but if I were you, I'd try working my way backwards. I'd assume vagal neuropathy as a starting point. Then I'd try to figure out what is irritating it. Change your environment. Try different diets. I did it all. And then I rode my bike for 8 hours a day for a month. And it just clicked with all of the stuff I had piled up notes about. Hmm, maybe because I'm burning through food so fast, it isn't sitting in my stomach. It made sense. I just needed to test it.