Oh how awful 
so what is the remedy, for esophageal spasms, lower chest pain, and palpitations, when your doctor wants to keep trying ppis or other meds, and refuses to refer for surgery? Are there any alternatives to a Nissen fundoplication? This is after colonscopy, camera pill, and endoscopy to confirm 30mm hiatus hernia. I keep telling the dox that the symptoms are probably from the hernia squeezing the vagus, but they’re adamant against the Nissen surgery! What else to do about this?
Talk to another doctor. If another doctor says no and agrees with your current doctor, then you should probably believe them. The new doctor, however, might be able to explain to you in better terms why this surgery is not your best option.
I am not a doctor, so don’t listen to me above them, but if the hernia had entrapped the vagus nerve, I wouldn’t expect to see lower chest pains and palpitations, I’d expect to see you losing consciousness and blacking out. While some lay people do think that stomach gas and a hernia can stimulate the vagus nerve and cause palpitations w/o other symptoms, it is not an accepted theory by many medical professionals, and there is little or no scientific evidence to support the theory.
It may also be that you have other risk factors - obesity, smoking, advanced age, frailty, bleeding condition, etc. - that make even laproscopic surgery too risky, unless you’re in a life threatening situation.
Have you asked your doctor why he won’t recommend the surgery for you? What does he say?
As for what to do in the meantime:
-Small frequent meals instead of large ones. Do not drink water or other liquids with your meals, but you should drink water between meals.
-Make sure you’re sitting upright for a full hour after you eat.
-Keep a food diary and see if you can find any “trigger” foods that make your symptoms worse. If so, don’t eat those foods. (Caffeine and spicy foods are common triggers, but some people react to things like green peppers or random stuff like bread.)
-Do not drink alcohol, which can relax the esophageal sphincter and cause worsening acid reflux into the esophagus. It can also relax the tissue around the hernia, temporarily enlarging the hernia and making entrapment of the stomach more likely.
-Put several pillows under your mattress to elevate the head of the bed while you sleep (this tends to work better than trying to sleep directly on 5 shifting pillows.)
-Avoid using aspirin or other NSAIDS (ibuprofen, naproxen, etc.) and use Tylenol for headaches and stuff instead.