A 33-year-old with classic GERD symptoms after an 8-week PPI course still has heartburn. No alarm features. Next step?...

Question

A 33-year-old with classic GERD symptoms after an 8-week PPI course still has heartburn. No alarm features. Next step?

Accepted Answer

EGD to evaluate refractory symptoms

Answer

Double PPI dose once daily

Answer

Switch to a different PPI once daily

Answer

H2 blocker add-on at bedtime only

Answer

Antireflux surgery immediately

us-abim MCQ (SBA): Refractory GERD