Question

A 45-year-old man presents with epigastric pain relieved by food and waking him at night. He takes ibuprofen regularly for back pain. H. pylori stool antigen is negative. What is the next step?

Accepted Answer

Stop NSAID and start full-dose PPI for 8 weeks

Answer

Start long-term PPI without review

Answer

Start H₂-receptor antagonist only

Answer

Add misoprostol to ibuprofen

Answer

Refer for urgent endoscopy

Practice question

A 45-year-old man presents with epigastric pain relieved by food and waking him at night. He takes ibuprofen regularly for back pain. H. pylori stool antigen is negative. What is the next step?