PEBC MCQ GI, Renal & Hepatic Disorders question: over-the-counter acid reducer

PEBC MCQGI, Renal & Hepatic Disorders

PS, 64, asks for an over-the-counter acid reducer. He has had heartburn for 3 months, now with food sticking in his throat and a 5 kg weight loss he did not intend. Which of the following is the most appropriate recommendation?

a. Calcium carbonate as needed and smaller evening meals
b. Refer him promptly; alarm symptoms must not be self-treated
c. Famotidine 20 mg twice daily for 2 weeks, then reassess
d. Omeprazole 20 mg daily for 14 days as a self-care course

Show the answer and explanation

Answer: b. Refer him promptly; alarm symptoms must not be self-treated

Dysphagia and unintentional weight loss are alarm features that may indicate esophageal stricture or cancer, and new symptoms after about age 60 also call for investigation. Canadian guidance advises referral for prompt endoscopic evaluation rather than self-treatment. Acid suppression could mask symptoms and delay diagnosis. Source: Moayyedi PM et al. ACG and CAG Clinical Guideline: Management of Dyspepsia (Am J Gastroenterol 2017;112:988); omeprazole nonprescription labelling (DPD, checked 2026).

Common mistake

Self-treating reflux in a patient with alarm symptoms.

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