Step 2

Gastrointestinal 2

A 58-year-old man presents to his primary care physician complaining of a week of nausea, vomiting, diarrhea, and intermittent sharp epigastric pain for the past month. The patient has tried over the counter pain medications and antacids which have not helped with the symptoms. He denies having any chest pain, palpitations, difficulty breathing, cough, fevers, hematochezia, or melena. However, he notes mild generalized weakness, dizziness, and lightheadedness. The patient immigrated from Japan twenty years ago, and he has been operating his own restaurant handling seafood. He is a current tobacco smoker and drinks alcohol occasionally. He had a cholecystectomy five years ago and a partial gastrectomy for a gastric ulceronemonth ago. He takes a multivitamin, atorvastatin, and omeprazole. Physical examination reveals stable vitals, a mildly distended abdomen, and hyperactive bowel sounds.

Which of the following will be the most beneficial for the patient?

  • A) Discontinue the statin
  • B) Fluid repletion and monitor for self-resolution
  • C) Start a high carbohydrate diet
  • D) Start a high protein diet
  • E) Start a low fiber diet

Authors

Yunjia Shen

Editor

Dr. Raj Dasgupta

Last updated

Dec 29, 2023

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