Description

WG is a 50yr old male presenting with abdominal pain for a few months. He has history of dyslipidemia, osteoarthritis, current moderate alcohol use, and 30 pack year smoking. He reports stomach feels tight, acid taste in mouth, kind of burning sense of indigestion. He also reports black colored bowel movements, and clear vomitus with black spots, lasting a couple of days with last events occurring couple months ago. Abdominal pain is slightly relieved with OTC chewable antacids and meals. He denies prescription medication, but states he takes OTC Ibuprofen and Aspirin 81mg daily. He denies diarrhea, constipation, continuous vomiting. Physical exam revealed hyperactive bowel sounds, moderate epigastric tenderness with palpation. Negative for hepatosplenomegaly, hernation, masses, abnormal pulsations. No guarding or rebound tenderness. Digital rectal exam negative.