Gastroesophageal Reflux Disease

A 55-year-old woman presents with symptoms of heartburn and an 8-year history of a sour, bitter taste in her mouth. Her symptoms have increased in frequency and severity over the past year and now occur daily, typically after meals and at nighttime. She has no dysphagia, odynophagia, weight loss, anorexia, or upper gastrointestinal bleeding. Her medical history includes hypertension (treated with lisinopril) and obesity; the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) is 31. She smoked a half pack of cigarettes daily for 20 years but stopped 15 years ago. She eats late dinners that usually include wine. She has tried antacids and famotidine (at a dose of 20 mg twice daily) for a few months with minimal effect on the symptoms. How would you manage this case?