Q. A 56-year-old man presents to the clinic with the primary complaints of a burning sensation in the chest and upper abdomen, mainly after meals, and a chronic cough for the past 7 months. These symptoms are bothersome at night and are not improving despite the over-the-counter antacids and H2 blockers he has been taking for months. He also reports a significant unintentional weight loss of 15 pounds over the last 6 months. He has no significant medical history and does not consume alcohol or tobacco. His family history is unremarkable.
On physical examination, he appears distressed. He has a body mass index (BMI) of 22, and his vital signs are within the normal range. Abdominal examination is essentially unremarkable. However, upon oral cavity examination, there are signs of dental erosion. His lung sounds are clear to auscultation.
Lab investigations reveal Hemoglobin: 11 g/dL and Mean Corpuscular Volume: 86 fL. His comprehensive metabolic panel (CMP) is normal. Esophageal manometry shows low lower esophageal sphincter (LES) resting pressure: 10 mm Hg.
What would be the most appropriate next step in the management of this patient?