A 62-year-old man has 4 months of heartburn and new progressive dysphagia to solids. He has lost 8 lb unintentionally. He has tried antacids with

Question

A 62-year-old man has 4 months of heartburn and new progressive dysphagia to solids. He has lost 8 lb unintentionally. He has tried antacids with partial relief. Physical examination is normal. Which of the following is the most appropriate next step in management?

Accepted Answer

Perform upper endoscopy

Answer

Prescribe long-term metoclopramide without evaluation

Answer

Start empiric peppermint oil

Answer

Order barium swallow as definitive therapy

Answer

Reassure and review in 1 year

Gastroesophageal reflux disease — USMLE Step 3 MCQ

A 62-year-old man has 4 months of heartburn and new progressive dysphagia to solids. He has lost 8 lb unintentionally. He has tried antacids with partial relief. Physical examination is normal. Which of the following is the most appropriate next step in management?