Oh sorry, maybe I should have explained. He's not having those symptoms, he's studying for step 2 and came across that question somewhere and can't seem to find an answer.
Thats OK, its easy to misinterpret things over the internet. This answer is my best guess, but of course I could be wrong. Please post here if you ever find the official answer and rationale.
If we take apart the question and see what info they are giving us, we can take our guesses as to what they are looking for.
25 years old
GERD symptoms persistant despite 4 months of treatment
Weight loss
I wouldn't say gastric CA would be the cause of weight loss. Not that its impossible, but I would think that is far fetched. Ulcers don't cause weight loss unless its due to anorexia secondary to pain. H. Pylori is transmitted by person to person contact. It's not uncommon for young adults to become infected.
They are telling you that the treatment is going on for 4 months because that is a long time for the treatment to be in place with no improvement. If they said 1 month, I would say that's borderline.
H. Pylori will cause persistant symptoms despite PPI or H2 given alone. This can be dx by EGD with biopsy, or by a blood and breath test. Since these are not options, EGD would be the choice.
persistant GERD + weight loss in a young person, I would conclude to be H. Pylori and would warrant an EGD rather than just starting PPI. They need a prevpac to treat this.
