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A 29-year-old man presents with intermittent epigastric discomfort, without weight loss or evidence of gastrointestinal bleeding. He reports no use of aspirin or nonsteroidal antiinflammatory drugs. A serologic test for Helicobacter pylori is positive, and he receives a 10-day course of omeprazole, amoxicillin, and clarithromycin. Six weeks later, he returns with the same symptoms. How should his case be further evaluated and managed?
Kenneth E.L. McColl (Wed,) studied this question.