paraphrase and avoid AI Patterns and simplify, and keep between 150 and 200 words: Ali, you presented a thorough and guideline-based approach to the diagnosis and management of GERD. One additional point to consider is the critical role of patient education regarding NSAID use. NSAIDs are a leading contributor to upper gastrointestinal complications, including peptic ulcers, erosive esophagitis, and worsening reflux symptomseven in the absence of visible mucosal injury. AccordingTai and McAlindon (2021), up to one-third of NSAID users develop foregut symptoms such as heartburn and regurgitation, and more than 70% may have endoscopic abnormalities despite minimal or no symptoms. This highlights the importance of discussing medication history, including over-the-counter NSAID use, which many patients may not disclose. Given this patient's daily alcohol use and epigastric tenderness, continued NSAID use could significantly increase the risk of GI bleeding or ulceration. Reinforcing the need to avoid NSAIDs and offering alternatives for pain management (such as acetaminophen or topical agents) should be a key component of the treatment plan. Educating patients about hidden risks promotes adherence and improves long-term GERD outcomes