4 Months Of Worsening in Medicine / Internal Medicine — 38yo Man | Gastroenterology | SMLE Q#11364

SMLE Question #11364

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-433

Last updated: February 2026
A 38-year-old man presents to an outpatient clinic with 4 months of worsening retrosternal burning and sour taste, especially after large meals and when lying flat. He has a 3-year history of GERD that was controlled on omeprazole, which he stopped 4 months ago. He denies dysphagia, odynophagia, weight loss, gastrointestinal bleeding, or other alarm symptoms. Physical examination is unremarkable. What is the most appropriate next step in management?

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