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GERD maintenance — ESEGH MCQ

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ModerateGastroenterologyGERD maintenanceESEGH

A 39‑year‑old patient with typical gastro‑oesophageal reflux disease remains symptomatic despite once‑daily proton pump inhibitor (PPI) therapy and seeks advice on long‑term management. Which of the following is correct regarding maintenance treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Long‑term PPI therapy is indicated for proven erosive oesophagitis or Barrett’s oesophagus

Option A is correct. NICE CG184 (2014, reviewed 2019) clearly recommends full‑dose long‑term PPI maintenance therapy for individuals with severe oesophagitis, and symptom‑controlling PPI use is customary in symptomatic Barrett’s oesophagus. The other options are inconsistent with UK guidance: sucralfate is not first‑line; discontinuing PPIs universally may risk relapse in those with complications; prokinetics are unsafe for long‑term use; and PPIs should be taken before the first meal, not necessarily at bedtime.

Reference: NICE Clinical Guideline CG184: Gastro‑oesophageal reflux disease and dyspepsia in adults (2014, reviewed 2019), Recommendations section, https://www.nice.org.uk/guidance/cg184/chapter/Recommendations