A 60-year-old with GERD refractory to once-daily PPI taken with breakfast admits to taking it at bedtime. What is the best next step?...

Question

A 60-year-old with GERD refractory to once-daily PPI taken with breakfast admits to taking it at bedtime. What is the best next step?

Accepted Answer

Increase PPI to twice daily taken 30-60 minutes before meals

Answer

Switch to H₂ blocker only

Answer

Add chronic metoclopramide

Answer

Stop PPI and test for H. pylori first

Answer

Add sucralfate

us-abfm MCQ (SBA): GERD-PPI Optimization