Case PresentationEsam Al AmadPatient PresentationExisting cues:22 year old Turkish female presented to the OPDMarried with 1 childPresenting cues:Complains of burning sensation in her chest of 2 days durationDifferential DiagnosisMost common: GERDDyspepsiaLess common:Biliary DiseasePeptic ulcerRare: MalignancyDiscriminative HistoryPatient denies any of the followingWeight loss, decrease in appetite, fatigue, night sweats or any low grade fever.Use of NSAIDsNausea or vomitingDark or black stoolSever abdominal pain/tendernessChills and rigorsSmokingAlcohol intakePositive historySymptoms occur after spicy and heavy meals.Worsened when leaning over, laying down flat, or with movement.Previous attacks of similar symptoms.Drinks coffee regularlyDiagnosisGastroesophageal Reflux DiseaseHeartburnManagementReassure the patient that her symptoms are due to heartburn which is an easily manageable condition by lifestyle and diet modification, and medication to alleviate her symptoms.AdviceAdvise the patient to avoid spicy food and large meals in order to prevent the occurrence of heartburn.Patient should avoid eating late at night and should wait a few hours before sleepingDecrease intake of caffeine and similar triggers.PrescriptionAntacids for symptomatic reliefDaily Proton for preventionReferralNo referral is needed for this patientInvestigationsNo further investigation are needed for this patientObservation and follow upOpen follow up: Patient should seek care if needed.Prevention22 year old female, non smoker, otherwise healthy. She should be advised on one of the following preventions:Blood pressure and Blood GlucosePap Smear-ask about previous pap smears, knowledge of Pap smear, and sexual activityExercise -explain the benefits of exercise and ask about patients exercise routineBreast Examination-ask about family history of breast malignancies, previous breast imaging, or breast examination. Establish known risk factors.