A 37-year-old patient presented for follow-up of recurrent upper abdominal pain. He initially presented 6 weeks ago, complaining of an increase in frequency and severity of burning epigastric pain, which he has experienced occasionally for more than 2 years. Now the pain occurs three or four times per week, usually when he has an empty stomach, and it often awakens him at night. The pain usually is relieved within minutes by food or over-the-counter antacids but then recurs within 2 to 3 hours.
He admitted that stress at work had recently increased and that because of long working hours, he was drinking more caffeine and eating a lot of take-out foods. Medical history – unremarkable, other than the antacids, he takes no medications. Physical examination - normal. Results of laboratory tests performed at his first visit show no anemia, but his serum Helicobacter pylori antibody test was…
