1. Based on your understanding of the function of the gastrointestinal system,
Steven is a 45-year-old store manager who is complaining of a burning, gnawing pain, moderately severe, almost always in the epigastric region. The pain is absent when he wakes up in the morning but appears about midmorning. It is relieved by food but recurs 2 to 3 hours after a meal. This pain often wakes him up during the night. Endoscopic examination of his gastrointestinal tract showed normal stomach anatomy but craters and inflammation were observed in the duodenum. Gastric analysis demonstrated that the gastric juice pH fell to 1.9 with pentagastrin stimulation (6 ug/kg s.c.). Fasting serum gastrin levels were normal. Include your references below.
1. Based on your understanding of the function of the gastrointestinal system, what do you think is the problem?
2. What is the significance of a pentagastrin stimulation test? (What is pentagastrin?) What is the significance of the fasting serum gastrin measurement?
3. Suggest some over-the-counter remedies to ease the symptoms. Why and how do these work?
4. Suggest some dietary alterations that may help get these symptoms under control. If the pain emanated from the stomach with acid reflux, would the management remain the same? What other diagnoses could be entertained?
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