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Discussion Starter · #1 ·
A 55-year-old white man with a 20-year history of gastroesophageal reflux visits the clinic for worsening reflux symptoms over the past 18 months. His last visit was 7 years ago and he claims to be otherwise in good health. He has been compliant with his antireflux medications, including an H2-blocker and a proton pump inhibitor. At this visit, it is most appropriate to perform which of the following?
(A) Double the dose of his H2-blocker and schedule him for follow-up in 4 weeks
(B) Double the dose of his proton pump inhibitor and schedule him for follow-up in 4 weeks
(C) Perform an esophagoscopy
(D) Schedule him for elective esophagectomy
(E) Schedule him for emergent Nissen fundoplication
 

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ans c

A 55-year-old white man with a 20-year history of gastroesophageal reflux visits the clinic for worsening reflux symptoms over the past 18 months. His last visit was 7 years ago and he claims to be otherwise in good health. He has been compliant with his antireflux medications, including an H2-blocker and a proton pump inhibitor. At this visit, it is most appropriate to perform which of the following?
(A) Double the dose of his H2-blocker and schedule him for follow-up in 4 weeks
(B) Double the dose of his proton pump inhibitor and schedule him for follow-up in 4 weeks
(C) Perform an esophagoscopy
(D) Schedule him for elective esophagectomy
(E) Schedule him for emergent Nissen fundoplication
ans C esophagoscopy
 

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Discussion Starter · #5 ·
Yes, it's C

Yes, you are right. We need to do esaphageoscopy to rule our Barrett's esophagus. Other options are not logical in this case.
Surgery is indicated only if you have active reflux that is resistant to medical therapy.
 
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