447) A 54 year old caucasian man is seen in your office for initial visit examination. He recently moved from Texas to your town and would like to establish care with you. He has no significant past medical problems except for Gastro-Esophageal Reflux Disease for twenty years. He previously suffered hearburn symptoms that were controlled with over the counter ranitidine . Later, his symptoms became refractory and he was started on omeprazole by his previous physician. He currently takes 20 mg of Omeprazole and is very happy that he has been asymptomatic for the past 1 year. He has had colonoscopy 2 years ago and this was normal. His father died of Colon cancer at the age of 70. He does not smoke.
Which of the following is the most appropriate action at this time ?
A) Instruct him to continue Omeprazole and follow up in 1 year.
B) Refer to gastroenterology for Upper Endoscopy
C) 24 hour Esophageal pH monitoring
D) Stool Guaic test and Flexible Sigmoidoscopy
E) Stool test for H.Pylori antigen
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