Question: A 24 year-old male presents with burning epigastric pain for the past month. The pain is relieved by food and antacids. He has been awakened by the pain several times. He has no dysphagia, nausea, vomiting, diarrhea, weight loss, melena or hematochezia. He has no past medical or surgical history and his only medicine is ibuprofen 600 mg three times a day for the past two months. He is using this for left knee pain after an injury. He drinks 1 to 2 beers on the weekends and does not smoke or use illicit drugs. Physical exam is significant only for epigastric tenderness. CBC is normal. Helicobacter pylori testing is negative. What is your next step? • Serum gastrin levels • Abdominal X-ray • Abdominal ultrasound • Refer to gastroenterology for an EGD. • Stop ibuprofen and treat with omeprazole.