A 60-year-old with symptomatic hiatal hernia and chronic GERD refractory to optimized PPI therapy asks about next step. What do guidelines support for...

Question

A 60-year-old with symptomatic hiatal hernia and chronic GERD refractory to optimized PPI therapy asks about next step. What do guidelines support for evaluation?

Accepted Answer

Esophageal manometry and ambulatory pH monitoring off PPI

Answer

Empiric baclofen trial only

Answer

Barium swallow only

Answer

Empiric prokinetic therapy

Answer

Immediate antireflux surgery without testing

us-abim MCQ (SBA): Refractory GERD

A 60-year-old with symptomatic hiatal hernia and chronic GERD refractory to optimized PPI therapy asks about next step. What do guidelines support for evaluation?