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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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