GERD

A 52-year-old man from Delhi presents with a 3-year history of heartburn occurring 2–3 times weekly, worse after heavy meals and when lying down at night. He denies dysphagia, weight loss, or alarm symptoms. Upper endoscopy performed 6 months ago was normal. He has tried antacids and H₂-blockers with partial relief. On examination, BMI is 28 kg/m², and abdominal examination is unremarkable. What is the most appropriate next step in management?

A 48-year-old woman from Mumbai presents with a 5-year history of progressive dysphagia to solids, regurgitation of undigested food, and chronic cough. She reports 6 kg weight loss over the past year. Upper endoscopy shows a dilated esophagus with a bird's-beak appearance at the gastroesophageal junction, and the scope passes with difficulty. Biopsy of the junction is normal. What is the most likely diagnosis?

A 52-year-old man from Delhi presents with a 3-year history of heartburn occurring 2–3 times per week, worse after heavy meals and lying down at night. He reports regurgitation of food and water brash. Physical examination is unremarkable. Upper endoscopy performed 6 months ago showed no Barrett's oesophagus or erosive changes. He has tried antacids and lifestyle modifications without sustained relief. What is the most appropriate next step in management?

Which of the following is the primary mechanism of action of proton pump inhibitors in the treatment of GERD?

In a patient with GERD refractory to standard-dose PPI therapy, which finding on 24-hour ambulatory pH monitoring would indicate inadequate acid suppression?