A 44-year-old man presents with a 45 days history of epigastric abdominal pain. He is suffering from burning pain, mostly at night or early in the morning. Eating food generally improves these symptoms. He admits to having had similar symptoms intermittently during the past several years, and over-the-counter H 2 receptor antagonists have always resolved his symptoms. He denies any weight loss, vomiting, or melena.
Examination His physical examination reveals a normal head and neck, and cardiopulmonary examinations show no abnormalities. The abdomen is nondistended, minimally tender in the epigastrium, and without masses. A rectal examination reveals Hemoccult-negative stool. Laboratory studies reveal normal WBC count, hemoglobin and hematocrit levels, platelet count, electrolyte levels, serum amylase level, and liver function tests. What is the most likely diagnosis and what…
