This in Medicine / Internal Medicine — 50yo Man | Gastroenterology | SMLE Q#16911
SMLE Question #16911
Medicine / Internal Medicine
Gastroenterology
Objective: OBJ-433
Last updated: February 2026
A 50-year-old man has several years of worsening heartburn and regurgitation, worse at night and after large meals. He has no weight loss, dysphagia, or hematemesis. Upper endoscopy shows a columnar-lined distal esophagus, and biopsies confirm intestinal metaplasia without dysplasia or malignancy. He has not used regular acid-suppressive therapy. What is the most appropriate initial management for this patient?
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