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A 40-year-old female presents with vague mid-to-low thoracic pain. She cannot pinpoint the exact pain, but says it is just general discomfort in that region. The patient mentions that she has also experienced long-standing abdominal pain and heaviness, with unpredictable, irregular bowel habits. Recently though, there has been a definite change to a mixture of constipation and loose stools; she thinks this may be because she has been eating a lot of 'carb-heavy' foods. There is no blood in her stools, no major weight loss, and she denies being 'stressed'. The patient mentions that she sometimes gets a skin rash after eating certain foods like pasta, but other than that she cannot pinpoint what else might contribute to the rash.
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