Question

A 63-year-old with chronic reflux has persistent symptoms despite optimal PPI therapy. He denies weight loss or dysphagia. What is the next step in managing his condition, according to NICE?

Accepted Answer

Test for Helicobacter pylori and treat if positive

Answer

Add a prokinetic agent like metoclopramide

Answer

Step up to high-dose PPIs indefinitely without investigation

Answer

Refer for an urgent endoscopy

Answer

Switch to H2 receptor antagonist only

Practice question

A 63-year-old with chronic reflux has persistent symptoms despite optimal PPI therapy. He denies weight loss or dysphagia. What is the next step in managing his condition, according to NICE?