For individuals with GERD, acetaminophen is generally the safest over-the-counter option for pain relief. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin, acetaminophen does not irritate the stomach lining or worsen acid reflux symptoms. If you require stronger pain relief or anti-inflammatory treatment, please consult your doctor. They can discuss safe prescription alternatives or recommend taking a stomach-protecting medication alongside an NSAID if it is absolutely necessary. Always aim to use the lowest effective dose for the shortest time.

Enlarged mesenteric lymph nodes are often a normal, protective response to mild inflammation or infection in the gut, explaining your slightly elevated ESR. Since this has persisted for six months, treatment focuses on addressing the underlying cause. For immediate symptom relief, a doctor may suggest generic antispasmodics (such as dicyclomine or mebeverine) for pain, and simethicone to reduce flatulence. Probiotics may also help regulate your digestion. Please do not worry, as reactive lymph nodes are very common and typically benign. I highly recommend consulting a gastroenterologist for a comprehensive evaluation to determine the exact cause and receive a targeted treatment plan.