A 70-year-old with long-standing GERD and obesity undergoes evaluation for refractory symptoms. Bravo pH shows abnormal acid exposure on BID PPI. Next...

Question

A 70-year-old with long-standing GERD and obesity undergoes evaluation for refractory symptoms. Bravo pH shows abnormal acid exposure on BID PPI. Next best management?

Accepted Answer

Anti-reflux surgery (fundoplication) consideration after optimization

Answer

Increase PPI to TID without considering surgery

Answer

Discontinue all therapy

Answer

Start H2RA only

Answer

Empiric antibiotics

"refractory gerd with objective reflux" MCQ (SBA): Refractory GERD with objective reflux

A 70-year-old with long-standing GERD and obesity undergoes evaluation for refractory symptoms. Bravo pH shows abnormal acid exposure on BID PPI. Next best management?