Chronic Headaches in Medicine / Internal Medicine — 34yo Woman | Gastroenterology | SMLE Q#18745

SMLE Question #18745

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-433

Last updated: March 2026
A 34-year-old woman has 3 weeks of burning epigastric pain worse 1–2 hours after meals and at night. She frequently uses ibuprofen for chronic headaches. She denies hematemesis, melena, weight loss, dysphagia, or persistent vomiting. Upper endoscopy shows a 1-cm clean-based duodenal bulb ulcer without active bleeding; gastric biopsies for Helicobacter pylori are sent and results are pending. What is the most appropriate next step in management?

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