52 year old with epigastric pain, acid reflux Sx, cough, dark tarry stools. No Hx of H. pylori infection or treatment.
Treatment
-Counseling: Don’t eat right before bed time, CAPA free diet, etc. Avoid NSAIDs
-CBC, CMP
-FOBT
-H. pylori Stool Antigen
-Protonix 20mg daily
–EGD (the diagnostic test of choice)
-Colonoscopy (pt is due for colonoscopy anyway)
-Hepatitis panel 2/2 previously elevated liver LFTs.