question: Q:A 52-year-old man comes to the physician because of a 3-month history of upper abdominal pain and nausea that occurs about 3 hours after eating and at night. These symptoms improve with eating. After eating, he often has a feeling of fullness and bloating. He has had several episodes of dark stools over the past month. He has smoked one pack of cigarettes daily for 40 years and drinks 2 alcoholic beverages daily. He takes no medications. His temperature is 36.4°C (97.5°F), pulse is 80/min, and blood pressure is 110/70 mm Hg. Abdominal examination shows epigastric tenderness with no guarding or rebound. Bowel sounds are normal. Which of the following treatments is most appropriate to prevent further complications of the disease in this patient?? 
  {'A': 'Truncal vagotomy', 'B': 'Amoxicillin, clarithromycin, and omeprazole', 'C': 'Fundoplication, hiatoplasty, and gastropexy', 'D': 'Distal gastrectomy with gastroduodenostomy', 'E': 'Intravenous vitamin B12 supplementation'},