Step 2

Gastrointestinal 2

A 58-year-old man presents to his PCP complaining of a week of nausea, vomiting, diarrhea, and intermittent sharp epigastric pain. 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, and melena. However, he notes mild generalized weakness, dizziness, and lightheadedness. Patient immigrated from Japan twenty years ago, and he has been operating his own restaurant handling seafood. Patient is a current smoker and drinks sake occasionally. He had a cholecystectomy five years ago and a partial gastrectomy for gastric ulcer a month ago. He takes multivitamins, atorvastatin, and omeprazole. Physical exam reveals stable vitals, mildly distended abdomen, and hyperactive bowel sounds.

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

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


Yunjia Shen


Dr. Raj Dasgupta

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