A 60-year-old male presents with a long history of heartburn and recent unintended weight loss. He mentions that he often wakes up at night because of a sour taste in his mouth. Recently, he has noticed that his food seems to stick when he swallows. What could be the potential diagnosis, and what are the next steps?
This patient's long history of heartburn symptoms and new-onset dysphagia (difficulty swallowing) is concerning for complications of long-standing GERD, such as an esophageal stricture or Barrett's esophagus with possible progression to esophageal cancer. Weight loss is an alarming symptom that warrants further evaluation. This patient should be referred for an endoscopy to visualize the esophagus, evaluate for complications, and obtain biopsies if necessary. He should also be started on proton pump inhibitor therapy.