Low-grade Dysplasia in Medicine / Internal Medicine — 56yo Man | Gastroenterology | SMLE Q#12092

SMLE Question #12092

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-433

Last updated: February 2026
A 56-year-old man has several months of frequent heartburn and sour regurgitation, worse when lying down. Upper GI endoscopy shows columnar-lined mucosa in the distal esophagus; biopsies show intestinal metaplasia with low-grade dysplasia. He has no weight loss, dysphagia, or gastrointestinal bleeding. What is the most appropriate initial pharmacologic management?

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