Patient history: A 37-year-old executive returns to your office for a 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 two 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 is usually 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 he was drinking more caffeine and eating a lot of take-out foods because of long working hours. His medical history and review of systems were otherwise unremarkable, and, other than the antacids, he takes no medications. Physical examination: His physical examination was normal, including stool…
