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Old 06-08-2012
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GIT Heartburn Treatment

A 34-year-old woman with severe heartburn presents for treatment. She reports heartburn 3 to 4 times per week but no dysphagia, nausea, or vomiting. She has a busy lifestyle and works 80 hours per week. She consumesone meal per day in the evening. However, she has been gaining weight over thepastyear. Although she smokes one pack of cigarettes per day, she is physicallyactive. There has been no hospitalizations or surgeries. What would be the most appropriate course of treatment?

(A) Proton-pump inhibitors daily for 3 months
(B) Lifestyle modification
(C) An upper endoscopy
(D) Upper gastrointestinal series
(E) 24-hour pH
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Old 06-08-2012
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E............?????
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Old 06-08-2012
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B Lifestyle modification
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E..............
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(B) Lifestyle modification
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Old 06-09-2012
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This pt is young and has no alarm sx. And since lifestyle mod hvn't been try yet, its the most appropriate to start with including small meals away form bedtime, weight loss and cutting smoking. Though the pt had SEVERE dz, i think ppi would be the most affective rx option but not the most appropriate at this time !
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Old 06-09-2012
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(B) Lifestyle modification
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Old 06-09-2012
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i think it is Lifestyle modification
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Old 06-10-2012
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Default qbank says

Lifestyle modification for this patient would be eating three meals per day (as opposed to one large meal), the discontinuance of tobacco use, and avoidance of weight gain. These are the most important aspects of treatment of mild gastroesophageal reflux disease.
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Gastroenterology-, Internal-Medicine-, Step-2-Questions

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