First, there are data on both sides of the PPI-Alzheimer’s link, and there hasn’t been a randomized controlled trial, so it is not absolutely certain PPIs cause dementia. But, I agree with the opinion that it’s best not to mess around with brain cells. I also think that severe reflux is so debilitating that what works is hard to give up. But be aware that these drugs affect vitamin B12 levels so that might be responsible for the potential link to dementia.
https://jamanetwork.com/journals/jama/fullarticle/1788456
There is a surgical treatment for reflux. I was lucky enough to have reflux surgery—fundoplication—before my bariatric surgery and I have never experienced reflux since. Preop patients should discuss this, because there is a surgeon doing fundoplication at the same time as sleeve gastrectomy. (I don’t think you can do it after DS or sleeve gastrectomy, since it uses part of the stomach.)
You might have a hard time finding someone to do it, and I don’t know if insurance companies approve it easily, but I see there is an FDA approved device that is like fundoplication, the LYNX. It is a ring of magnetic beads that open when eating and close after eating to prevent acid from refluxinginto the esophagus. And it only involves the esophagus, so your DS may not be a contraindication. I don’t know. They do it at NYU in NY and USC in California and I am sure other places.
http://www.surgery.usc.edu/uppergi-general/gastroesophagealrefluxdisease-linx.html