Question

A 54-year-old man presents with 3 months of progressive dysphagia for solids and unintentional weight loss of 6 kg. He has long-standing gastro-oesophageal reflux disease previously controlled on proton pump inhibitors. Examination is unremarkable. What is the most appropriate next step in management?

Accepted Answer

Arrange urgent upper gastrointestinal endoscopy

Answer

Increase his proton pump inhibitor to maximum dose and review in 3 months

Answer

Order a barium swallow only

Answer

Start prokinetic therapy such as metoclopramide

Answer

Reassure him that symptoms are likely functional and observe

Practice question