Question

A 52-year-old man presents with heartburn, sometimes associated with reflux of sour-tasting material into the mouth. Some of these episodes are accompanied by increased salivation and coughing. He denies any bleeding or abnormalities in his stools. He is slightly overweight and has mild hypertension, which is well controlled with enalapril. Vital signs are within normal ranges and the physical examination is unremarkable. An upper endoscopy reveals coalescing linear erosions throughout the esophageal circumference and a 5.5-cm-long, circumferential cherry-red patch above the gastroesophageal junction. Biopsy of the patch reveals columnar metaplasia, but no dysplasia.

What can improve the patient's symptoms most effiiciently?

1. Laparoscopic fundoplication
2 Start omeprazole
3 Esophagectomy
4 Radiofrequency thermal coagulation of the lower esophageal wall
5 Laser ablation of the Barrett's mucosa

Answer 1

Starting omeprazole would be the most efficient way to improve the patient's symptoms of heartburn and reflux.

Step-by-step explanation:

In the case of the 52-year-old man presenting with heartburn and reflux, the most efficient way to improve his symptoms would be to start omeprazole, option 2. Omeprazole is a proton pump inhibitor (PPI) that reduces the production of stomach acid, which can help alleviate heartburn and prevent reflux. This medication is commonly used to treat gastroesophageal reflux disease (GERD) and can provide significant relief for the patient.