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.

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.

White patches on the tongue can develop due to vitamin deficiency, acidity with reflux, fungal infection, mouth irritation, dehydration, smoking, poor oral hygiene, or repeated stomach acid exposure. Since you noticed improvement after using Nexpro RD Capsule and vitamin B12, the patches may possibly be related to acidity, nutritional deficiency, or irritation inside the mouth. However, the exact cause can only be confirmed after proper examination. Maintaining good oral hygiene, drinking enough water, and avoiding tobacco, alcohol, spicy foods, or very hot beverages may help the tongue heal more comfortably. Gently cleaning the tongue and following regular meal timings may also reduce irritation from acidity. Medicines and supplements should be continued only according to the doctor?s advice because unnecessary long-term use may not always be needed once the condition improves. Further evaluation becomes important if the white patches become painful, spread, bleed, cause difficulty swallowing, or do not clear completely after treatment, as some tongue conditions may require examination.

While an MRI is a wonderful tool that avoids radiation, neither an MRI nor a CT scan can clearly show mild stomach irritation, redness, or swelling. These imaging tests look at deeper structures rather than the delicate inner lining of your stomach. An endoscopy (scope) remains the gold standard for seeing mucosal irritation. Please be reassured that your Nexpro RD (esomeprazole/domperidone) is actively working to soothe and heal your stomach lining. I recommend sharing your current symptoms with your doctor to guide your next steps safely.

It is generally safe to take Crocin 650 (paracetamol) alongside your current medications, including metoprolol (Prolomet XL), esomeprazole (Nexpro RD), rosuvastatin (Rosuvas), vitamin E (Evion), obeticholic acid (Obetohap), and escitalopram/clonazepam (Nexito Plus). However, because you are taking obeticholic acid, please limit paracetamol to a maximum of two tablets (1300 mg) in 24 hours, and consult your doctor first to ensure your liver is fully protected. To help soothe the pain safely, you can also try resting, applying a warm compress, or using a topical pain-relief gel.

Antibiotics can sometimes disrupt your natural gut flora, leading to inflammation. Since the probiotics and Nexpro RD have not provided relief, it is very important to consult your healthcare provider or a gastroenterologist. They can evaluate you for antibiotic-associated issues, such as specific gut infections or colitis, which require targeted treatments. Please avoid starting new self-medications, stay well-hydrated, and eat simple, bland foods while you wait to see your doctor.