A 56-year-old woman with no medical comorbidities presented to her primary care clinician with postprandial retrosternal burning that occurred multiple times daily for several years. She had no dysphagia, gastrointestinal bleeding, weight loss, anemia, or exertional chest pain. Over-the-counter antacids provided incomplete benefit. She was prescribed proton pump inhibitor (PPI) therapy with esomeprazole 40 mg, which she took daily, 30 minutes before breakfast. Her heartburn did not improve and continued to bother her daily despite adding famotidine at bedtime.
Patel A, Gyawali CP. Gastroesophageal Reflux Monitoring. JAMA. 2018;319(12):1271–1272. doi:10.1001/jama.2018.1144
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