A 48 year old man presents with retrosternal burning after large meals and when lying flat. He denies weight loss, dysphagia or bleeding. Lifestyle me...

Question

A 48 year old man presents with retrosternal burning after large meals and when lying flat. He denies weight loss, dysphagia or bleeding. Lifestyle measures and a 2 week trial of a proton pump inhibitor have partially relieved symptoms. What is the most appropriate next step?

Accepted Answer

Continue proton pump inhibitor therapy at an adequate dose for 8 weeks and reassess

Answer

Refer urgently for endoscopy as all reflux needs immediate investigation

Answer

Start long term high dose NSAIDs

Answer

Order barium swallow instead of endoscopy if symptoms persist

Answer

Reassure only as symptoms are functional

ca-mccqe1 MCQ (SBA): Gastro-oesophageal reflux disease

A 48 year old man presents with retrosternal burning after large meals and when lying flat. He denies weight loss, dysphagia or bleeding. Lifestyle measures and a 2 week trial of a proton pump inhibitor have partially relieved symptoms. What is the most appropriate next step?