53-year-old woman with persistent reflux symptoms despite PPI

You are evaluating a 53-year-old woman for reflux symptoms that have persisted for the last year despite proton pump inhibitor (PPI) therapy. She denies dysphagia, early satiety, or weight loss, and laboratory studies do not demonstrate anemia.

She underwent screening colonoscopy 3 years ago that was complete to the cecum, and no polyps or lesions were identified.

Upper endoscopy is performed, and several small polyps are found in the body of the stomach (see Figure).

Figure.

Biopsy was performed of the mild erythema in the body and antrum, the findings of which are negative for the presence of Helicobacter pylori–like organisms. Biopsy is also performed on several of the polyps, and the results are consistent with fundic gland polyps (FGPs).

What should you recommend with regard to the management of these FGPs?

• No further work-up or testing is indicated.
• Refer the patient for a clinical genetics evaluation.
• Schedule the patient for polypectomy.
• Repeat upper endoscopy in 6 months.

This question appears in Med-Challenger Internal Medicine Exam Review with CME

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