Question

A 42-year-old woman presents with a 6-month history of recurrent epigastric pain, bloating and early satiety. Alarm features include 5 kg weight loss and occasional melaena. What is the most appropriate next step in management?

Accepted Answer

Upper gastrointestinal endoscopy to evaluate for peptic ulcer disease and malignancy

Answer

Empiric proton pump inhibitor therapy only

Answer

Non-invasive H. pylori testing and treat if positive, no further workup

Answer

Abdominal ultrasound only

Answer

No further investigation; reassure and review in a year

Practice question

A 42-year-old woman presents with a 6-month history of recurrent epigastric pain, bloating and early satiety. Alarm features include 5 kg weight loss and occasional melaena. What is the most appropriate next step in management?