Question

A 50 year old male patient has had symptoms of GERD for the past 6 months. At the last visit, the NP began the patient on ranitidine (Zantac). At today's visit, 10 weeks later, the patient continues to complains that he has a sour sensation in his throat. Which of the following is the preferred next step in his case?

a. Increase patient dose of ranitidine (Zantac) from 150 mg to 400 mg
b. Add esomeprazole (Nexium) 20 mg
c. Refer patient to a dietician
d. Refer patient to GI for upper endoscopy/biopsy

Answer 1

For a patient with persistent GERD symptoms after taking ranitidine, the next step is to refer to a gastroenterologist for an upper endoscopy/biopsy to rule out serious underlying conditions.

Step-by-step explanation:

The preferred next step for a 50-year-old male patient who has symptoms of GERD and continues to experience a sour sensation in his throat, despite taking ranitidine (Zantac), is d. Refer patient to GI for upper endoscopy/biopsy. Given the patient's age and the persistent symptoms after medication intervention, it's important to rule out more serious conditions that might be causing the GERD-like symptoms, such as esophageal strictures, Barrett's esophagus, or esophageal cancer. Consultation with a gastroenterologist for further diagnostic testing is warranted. Dietary and lifestyle modifications can also be considered to manage symptoms alongside pharmacologic treatment.