P.A. is a 27-year-old healthy primigravida who is currently 24 weeks pregnant with a single fetus. She has a history of gastroesophageal reflux disease (GERD) diagnosed several years ago. At that time she took daily omeprazole for symptoms that occurred approximately 3–5 times per week, 1–2 times per day. Her BMI was 26 (ideal BMI 18.5–24.9), and weight loss was recommended. Over the course of a year, she managed to lose weight with diet and exercise. Her symptoms improved, nd, ultimately, she was able to discontinue omeprazole without diffculty. She never underwent endoscopic evaluation, as her symptoms were uncomplicated and resolved with proton pump inhibitor (PPI) therapy. Her mother is overweight with hypertension and her maternal grandfather has diabetes. She has one younger sibling whose only medical issue consists of seasonal allergies. She has no family history of gastrointestinal malignancies. She is a nonsmoker and denies current alcohol consumption.