Gastroenterology Q44

A 45-year-old man is evaluated for a 2-month history of a burning sensation starting in his stomach and radiating into his chest, usually occurring 4 to 5 times weekly. He says that he usually eats dinner late and then goes to sleep. He often wakes up with a sour taste in his mouth. He reports no dysphagia or unintentional weight loss. He takes no medication. On physical examination, vital signs are normal; BMI is 34. The remainder of the examination, including abdominal examination, is unremarkable.

Which of the following is the most appropriate next step in management?

A Ambulatory pH testing

B Barium esophagography

C Empiric trial of a proton pump inhibitor

D Upper endoscopy

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