Question

A 42-year-old man presents with long-standing epigastric discomfort, heartburn and regurgitation, worse after meals and when lying down. He takes over-the-counter antacids with partial relief. There are no alarm features. BMI is 29 kg/m². What is the most appropriate initial management strategy?

Accepted Answer

Trial a standard-dose proton pump inhibitor for 4-8 weeks plus lifestyle modification

Answer

Arrange urgent upper GI endoscopy

Answer

Start long-term proton pump inhibitor therapy and no lifestyle changes

Answer

Start H pylori eradication therapy empirically

Answer

Order CT abdomen

Practice question

A 42-year-old man presents with long-standing epigastric discomfort, heartburn and regurgitation, worse after meals and when lying down. He takes over-the-counter antacids with partial relief. There are no alarm features. BMI is 29 kg/m². What is the most appropriate initial management strategy?