Hi
I know you have said that he has been allergy tested but is he and you dairy free? 42% of our babies with reflux are allergic to cow's milk protein. Even if allergy tests are negative it is worth you trialling the dairy free diet for two weeks. The other food we recommend avoiding until 12 months is gluten - wheat, rye, barley and oats. You don't necessarily need to avoid them unless he does have an allergy to them but we recommend not introducing them until 12 months.
Other than finding food causes it seems obvious to me from what you have said that he needs treating for reflux. Long term acid exposure can cause significant problems so it is a weigh up of having bubs on medication and side-effects, or possible long-term damage to the oesophagus, feeding issues and sleep deprivation.
Often our babies with reflux have constipation anyway because their whole gut doesn't move food through as fast as it should. It is best to treat the constipation and treat the reflux also.
You could start with treating reflux with just Gaviscon Infant before bed. It may cause constipation but is a really useful medication for reflux and may be enough alone. It will decrease or stop spilling, and therefore the pain associated with it. You may need to treat the constipation as I said earlier.
Did Ranitidine stop working? It is more common for this to cause constipation than Losec though and the dose needs adjusting frequently for weight gain.
Night-time issues may be helped by a probiotic along with the Losec. Losec will not help spilling.
There are also lots of other natural alternatives that may help. Aloe Vera juice is great and good for allergies also. Tastes disgusting. Slippery elm is soothing, coats the oesophagus and gut, and helps with constipation. Chammomile is soothing on the stomach, and aids sleep. Balmac Pharmacy in Dunedin has an rememdy called Rhugar made from ginger and rhubarb. And there are heaps more ideas in our Alternative Therapies section of Crying Over Spilt Milk.
Hope some of my suggestions help.