Gastroenterology
Case 25: A Patient with Reflux and Increasing Heartburn
CASE
A 52‐year‐old man is referred back to the gastroenterology clinic. He was diagnosed as having reflux on the basis of an endoscopy performed 10 years previously. Since that time he has been taking omeprazole 20 mg daily. Over the last year he has had increasing problems with heartburn and belching (northerly wind) and has been using over the counter antacids. He has gained 12 kg in weight over the last 18 months and claims to be under a lot of stress going through a difficult divorce. He is otherwise physically well. He was recently started on a calcium antagonist for hypertension and a statin for hypercholesterolaemia.
On examination he weighs 94 kg (BMI 34). Examination is otherwise unremarkable. His blood tests were normal.
He recently underwent a repeat endoscopy. He remembers belching and retching a lot during the procedure which he chose to have done under local anaesthetic spray only. He was told that the examination was ‘unremarkable’.
QUESTION 1
Your score this session: 0 of 0
What is the source of belching?