Reference no: EM133231308

Mr. Cue age 60 comes to your office today complaining of epigastric pain worsening over. He reports "heartburn" in the past but it has always been relieved with antacids before. On your review of systems, he reports that he has been having indigestion off and on over the last year, and now epigastric pain rated a 7/10 that has progressively gotten worse since onset 3 weeks ago. He has tried antacids, but it hasn't seemed to help. Nothing seems to make it better or worse, although it "does sometimes get a little better when I eat but comes back after a few hours". He describes it as sharp pain, sometimes burning, and seems worse at night. No other associated symptoms.

1. What diagnostic tests would you do at this visit and why? Would you order an upper endoscopy and why or why not? What might you expect to find for a patient with this clinical presentation?

2. Explain the pathophysiology of your chosen diagnosis and what medication might assist in bringing resolution to the problem?

3. What education, including risk reduction, would you review with the patient prior to him leaving your office?