Normal cardiac stress test (TMT) and ultrasound (Echo) results are generally reassuring for 1 to 2 years, provided symptoms do not change. Your symptoms?chest heaviness, arm pain, and burping?could certainly be related to acid reflux (GERD), especially since you are taking esomeprazole (Nexpro RD). However, because these symptoms can mimic heart issues, and you recently switched to propranolol (Inderal), it is important not to ignore them. Please consult your doctor to safely evaluate these ongoing symptoms and see if your reflux or heart treatment needs adjusting.

Acid reflux is usually a long-term condition and may not be completely curable. Its long-term effects can include oesophageal inflammation, ulcers, narrowing of the oesophagus, Barrett's oesophagus, and an increased risk of oesophageal cancer. Even with medication, symptoms may persist if the underlying causes remain untreated.

Frequent stomach burning and burping are often caused by acid reflux, gastritis, or indigestion. Avoid spicy and oily foods, eat smaller meals, stay upright after eating, and consult your doctor if symptoms persist, as treatment with antacids or acid reducers may be needed.

It is generally best to avoid taking azithromycin with Nexpro RD (which contains domperidone) because combining them can affect your heart rhythm. Additionally, antacids like Rantac MPS can interfere with how your body absorbs azithromycin, so they should be taken at least two hours apart. Your symptoms of heartburn, chest and back pain, stomach noises, and breathing discomfort are likely related to severe acid reflux. However, because chest pain and breathing difficulties require careful evaluation, please consult your doctor before starting the antibiotic.

Dealing with persistent heartburn and stomach pain can be exhausting. Nexpro RD 40 (esomeprazole/domperidone) reduces stomach acid, but its effects can be overridden by other medications. Your lung medication, Pulmifib (pirfenidone), frequently causes gastrointestinal side effects like acid reflux and stomach ache, while Mucinac (acetylcysteine) can also irritate the stomach lining. This explains why your symptoms persist despite the antacid. Please do not stop your respiratory treatments. I highly recommend consulting your doctor to discuss adjusting the timing of your doses or modifying your acid-reducing therapy to help you find relief and sleep better.

The medications you have tried, including PPIs like esomeprazole and rabeprazole, help reduce acid and improve gut motility, but since they haven't provided relief, your symptoms might not be solely acid-related. I highly recommend consulting your gastroenterologist again. They may consider testing for food sensitivities, small intestinal bacterial overgrowth (SIBO), or functional gastrointestinal disorders. Please don't lose heart; finding the right solution often takes a bit of time and specialized guidance.