<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 30-year-old man presents with heartburn for the past couple of weeks. He says he feels a burning sensation in his chest, at times reaching his throat, usually worse after eating spicy foods. He is overweight and actively trying to lose weight. He also has tried other lifestyle modifications for the past couple of months, but symptoms have not improved. He denies any history of cough, difficulty swallowing, hematemesis, or melena. The patient says he often drinks a can of beer in the evening after work and does not smoke. His blood pressure is 12482 mm Hg, pulse is 72min and regular, and respiratory rate is 14min. Abdominal tenderness is absent. Which of the following is the next best step in the management of this patient?? A: Start omeprazole., B: Start sucralfate., C: Start famotidine., D: Start oral antacids., E: H. pylori screening,  <response>: This is a patient with typical symptoms of gastroesophageal reflux disease GERD. The key findings are heartburn, worse after eating spicy foods, and not improving with lifestyle modifications. There are no alarm symptoms like difficulty swallowing, hematemesis, or melena. The choices include starting different medications like PPIs omeprazole, H2 blockers famotidine, mucosal protectants sucralfate, antacids, and H. pylori screening. In a patient with typical GERD symptoms like this, and no alarm features, the next step would be to start a trial of a PPI like omeprazole. H. pylori screening is not routinely indicated in GERD. Sucralfate, famotidine, and antacids may help with symptoms but are not first-line.A: Start omeprazole. 