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Gastrointestinal and Hepatic — Abdominal pain

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Case 1 of 5Gastrointestinal and HepaticAbdominal pain (e.g., gastroesophageal reflux disease, peptic ulcer disease, dyspepsia)

A 50-year-old man presents to your office with a 2-week history of mid-epigastric discomfort and excessive belching. The symptoms are worse when he lies down to sleep, especially after a heavy meal. He also notices symptoms after he drinks a few beers and smokes with his friends over the weekend. There is no history of diarrhea or vomiting. On examination: blood pressure 130/90, heart rate 90, temperature 98°F, respiratory rate 13, BMI 30 kg/m2.

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What is the most likely diagnosis?

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