Question

A 49-year-old man reports chronic heartburn and regurgitation, partially relieved by over-the-counter antacids. Over the last 2 months, he has developed dysphagia to solid foods and a 10-lb unintentional weight loss. What is the most appropriate next step in management?

Accepted Answer

H. pylori stool antigen test and treat if positive.

Answer

Empiric proton pump inhibitor therapy for 8 weeks without further testing.

Answer

Order a barium swallow study only.

Answer

Upper endoscopy to evaluate for structural lesions or malignancy.

Answer

Reassurance and lifestyle modification alone.

Practice question

A 49-year-old man reports chronic heartburn and regurgitation, partially relieved by over-the-counter antacids. Over the last 2 months, he has developed dysphagia to solid foods and a 10-lb unintentional weight loss. What is the most appropriate next step in management?