A 52-year-old man presents with long-standing heartburn and regurgitation. He has been taking over-the-counter antacids with partial relief. Over the ...

Question

A 52-year-old man presents with long-standing heartburn and regurgitation. He has been taking over-the-counter antacids with partial relief. Over the past 3 months he has developed dysphagia to solids and has unintentionally lost 6 kg. He does not drink alcohol or smoke. What is the most appropriate next step in his management?

Accepted Answer

Arrange an urgent upper gastrointestinal endoscopy

Answer

Start a proton pump inhibitor and review in 3 months

Answer

Order a barium swallow only

Answer

Test for Helicobacter pylori with a urea breath test and treat if positive

Answer

Reassure him and provide lifestyle advice only

au-amc MCQ (SBA): Gastro-oesophageal reflux disease with alarm features