A 54-year-old with persistent reflux symptoms despite BID PPI is evaluated. pH testing off PPI confirms pathologic acid exposure and manometry is norm...

Question

A 54-year-old with persistent reflux symptoms despite BID PPI is evaluated. pH testing off PPI confirms pathologic acid exposure and manometry is normal. Next step?

Accepted Answer

Anti-reflux surgery (laparoscopic fundoplication) consideration

Answer

Empiric baclofen indefinitely

Answer

Stop all therapy; reassurance

Answer

Esophageal stent

Answer

Cholinergic agonist therapy

us-usmle-step-2 MCQ (SBA): Refractory GERD

A 54-year-old with persistent reflux symptoms despite BID PPI is evaluated. pH testing off PPI confirms pathologic acid exposure and manometry is normal. Next step?