Barrett’s Esophagus: Evaluation and Management

history The patient has no significant past medical history other than being overweight. He drinks 1 glass of wine per day and does not smoke. Family medical history is unremarkable for any malignancies. He does not exercise because he “works all the time” and has gained approximately 22 lb over the last year. The patient describes his heartburn symptom as a substernal “burning” sensation, which occurs approximately 30 minutes after eating and lasts approximately 1 to 2 hours. He was taking omeprazole 20 mg daily with antacids as needed and his symptoms were well controlled on this regimen; however, recently his symptoms have persisted despite these medications, and his dose of omeprazole was increased from 20 mg daily to 40 mg twice daily. This has resulted in only minimal improvement of his symptoms.