In a young, otherwise healthy patient with a newly suspected diagnosis of PUD, what would be the MOST appropriate course of action in the ED?

There are several approaches to the patient with suspected PUD. Traditional therapeutic regimens heal the ulcer, relieve pain, and prevent complications, but do not prevent recurrence. Therapy with an H2 receptor antagonist, proton pump inhibitor, sucralfate, or antacids would be appropriate. They have all been shown to heal ulcers equally well when used alone, and combination therapy is rarely necessary. Treatment of H. pylori infections is usually reserved for patients with documented infection. Serologic testing is used to detect H. pylori, and the breath test (using carbon-labeled urea) is used primarily after treatment to confirm eradication of infection. Immediate referral for definitive diagnosis by endoscopy may be indicated with concerning symptoms but is not necessary in an otherwise healthy patient.