At the Medicine Grand Rounds held approximately 1 year ago, Dr Robert Glickman discussed the management of peptic symptoms in a man who has experienced intermittent epigastric pain since childhood.1 Dr Glickman discussed the differential diagnosis of peptic ulcer disease and nonulcer dyspepsia with a focus on Helicobacter pylori as an etiologic agent, as well as the risks and benefits of empirical therapy for H pylori. Dr Glickman also addressed issues unique to the patient, Mr H: prior alcohol use, smoking, and attentiondeficit hyperactivity disorder (ADHD). We asked the patient and his primary care doctor to comment on what has happened in the year that has passed.
Mr H, the patient: I feel wonderful. I had an endoscopy, which went great, and it showed no evidence of an ulcer, past or present. I was probably misdiagnosed way back, and instead I really have a nervous stomach. I began school
Delbanco TL, Daley J. A 35-Year-Old Man With Epigastric Pain, 1 Year Later. JAMA. 1996;275(9):722. doi:10.1001/jama.1996.03530330066032