A 30-year-old patient who was born in Colorado presents to the primary care provider with 2 months of post-prandial
A 30-year-old patient who was born in Colorado presents to the primary care provider with 2 months of post-prandial epigastric pain described as burning. The pain is localized, and without associated nausea, emesis, melena, dysphagia, or odynophagia. OTC chewable calcium carbonate has provided relief as needed, but over the past month, he has had to increase the frequency of use to four times daily. He is a non-smoker, drinks 4 beers per week, reports no NSAID use, and tolerates his usual daily jog without fatigue or dyspnea. Blood pressure is 120/71 mm Hg. Pulse is 75 beats/minute and regular. Weight is unchanged from prior visits. Physical exam reveals minimal epigastric tenderness on palpation but is otherwise normal. Which of the following is the most appropriate medical intervention at this time? Choose the single best answer. A. Eight-week trial of pantoprazole once a day B. Fecal immunochemical testing (FIT) C. Fecal occult blood testing (FOBT) D. H. pylori IgG serologic testing E. Upper endoscopy with biopsy
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