I have taken PPI’s for a length of time. It’s a huge quality of life issue for me. Without reflux I can comfortably eat and enjoy my food, and better meet my calorie needs. Also, I think avoiding aspiration is very important for prevention of reinfection from MAC and other organisms that can cause serious infections. The PPI will interfere with absorption of many calcium supplements including calcium carbonate, so choose a calcium citrate supplement. It doesn’t need an acid environment for absorption, Hope this helps.