Burning

Gastrointestinal System


Step 1: View Clinicals

{"ops":[{"insert":"A 55 year old woman presents with mild epigastric pain, and intermittent heartburn and regurgitation for the past 2 years. She has also experienced intermittent watery diarrhea for the last 6 months.\n\nShe underwent an endoscopy 4 months ago, which revealed a duodenal ulcer. Tests for Helicobacter pylori were negative.\n\nSubsequently, she was started on a course of Pantoprazole for 4 weeks. When her symptoms did not resolve, the drug was increased to the maximum permissible dose, which has been continued until now.\n\nShe is not on any other medications and maintains that she has not used any over-the-counter formulations during the past year. Her surgical and family histories are unremarkable.\n\nShe has never smoked, and only drinks socially.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-094_en.png"}},{"insert":"\n"}]}

Step 2: Order Relevant Investigations

1. Repeat Endoscopy
2. Fasting Serum Gastrin
3. Somatostatin Receptor Scintigraphy
4. Diagnostic Laparoscopy

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