Shan Min:Good Min: Good Afternoon, doctor. Shan Min:Good Min: Good afternoon. What is your problem? P:I P:I have a stomachache. Shan Min:What Min: What do you feel? P:I P:I have a stron pain and heartburn. Shan Min:!o" Min: !o" lon have you had this pain and acidity? P:#or P:#or $ months no". It does not o "ay% I eat and after every meal my stomach hurts. &ven at niht the pain persists. Shan Min:'ell Min: 'ell me, in the last $ months, have you eaten any (ind of heavy food, or somethin different? P:)o. P:)o. Shan Min:!o" Min: !o" stron is the pain. *ets say in a + to + scale, ho" "ould you describe the intensity of the pain? P:-et"een P:-et"een /0 Shan Min:Is Min: Is the pain continuous or does it come and o? P:It P:It come and oes. Shan Min:1oes Min: 1oes the pain come after meals? P:'hat2s P:'hat2s possible because it hurts everytime after eatin. Shan Min:Is Min: Is there a (ind of food that affects you more? P:Greasy P:Greasy food.
Shan Min:Greasy food affects you? P:3es. At home "e eat a lot of reasy food. Shan Min:Where in the abdomen does it hurt? Point please% 1oes the pain travel to your chest, shoulder, bac( or across your abdomen? P:It hurts in the middle. Sometimes, the pain travels across my abdomen. Shan Min:-esides the pain, you said you have heartburn? P:3es, after a burp, I feel a (ind of sour taste. Shan Min:1o you feel li(e this more durin the day or in the evenins? P:-oth. I feel the acidity durin the day and at niht. Shan Min:Is it "orse "hen lyin do"n? P:3es, I taste the acid in my mouth? Shan Min:-esides reasy food, is there any other (ind of food that irritates your stomach? *i(e spicy food? P:)o, at home "e don2t eat spicy food. Shan Min: And tell me, ho" often do you reularly have a bo"el movement? !as that chaned since you have been havin these problems? P:It is reular. It hasn2t chaned since the problem. Shan Min:!ave you noticed any chane in the consistency of the bo"el movement? P:3es. It is a bit softer.
Shan Min:!ave you noticed any chane in color? P:3es, it is reener. Shan Min:Greener, not dar(er? Any blood in your bo"el movement or blac( colorin to bo"el movement? P:)o, not dar(er. I do not see any blood in my bo"el movement, either. -ein e4amination of the patient Shan Min:5(. What "e can do first is chec( your abdomen to see "here the pain comes from. 3ou said the pain comes from the middle/part of your abdomen? P:6orrect. Shan Min: And does the pain move some"here else, or does it stay there? P:It usually stays there. Shan Min:-ut "ith the pain, do you al"ays feel acidity? P:6orrect. Shan Min:1o you have nausea or vomitin? P:)o, not no". Shan Min:'ell me, "hat did you eat today? P:I ate meat "ith tomato sauce. Shan Min:1o tomatoes ive you any trouble? P:)o, I have al"ays eaten tomato sauce. Shan Min:What about orane 7uice, does it affect your stomach?
P:Sometimes. Shan Min:What do you feel? P:It ives me a strane metallic taste. Shan Min:-ut it does not you any acidity? P:)o, it doesn2t. Shan Min: And "hat do you do "hen you have stomachaches? P:Sometimes I ta(e Al(asel8er. It helps a bit. Shan Min:3es, it helps. 1o you ta(e any 'ums, Mylanta, Maalo4? P:)o. Shan Min: Are you ta(in or have you been ta(in no" or before this problem any medication on a consistant basis, li(e aspirin, Advil, Motrin, etc. P:)o, usually 'ylenol. Shan Min: And if you ta(e aspirin, or any other (ind of anti/inflammatory medicine, do you thin( it could affect your stomach? P:)o, I can2t really tell you. Shan Min:5(. As I "as tellin you before, I am oin to e4amine you. I "ant to e4amine your feces to chec( if you have any (ind of parasite. 1o you come from the tropics, or have you traveled any"here recently such as the tropics, or overseas? P:3es.
Shan Min:!ere in the 9nited States, as "ell as in any other part of the "orld, one can find parasites. 'hese can affect your stomach. -esides this, I "ant to loo( for any occult blood. 3ou said you have not really seen any chanes in your feces. It is only reener, but not dar(er. 'he diested blood, in case you have somethin in your stomach and you could have a haemorrhae, could produce a chemical reaction so that you can have occult blood in your feces. Many times "e don2t see the red color of blood or the blac( color of the diested blood therefore an e4amination is necessary. I "ould also li(e to e4amine your upper astrointestinal system throuh ;/rays and contrast. It is a very simple thin and it does not hurt. 3ou "ill drin( a thic( substance. 'he radioloist "ill see ho" you diest the substance and "ill see the movements of your stomach. We "ill have this type of e4amination because your pain could not come from the stomach but from the all/bladder. After the e4amination, "e "ill decide "hat to do first, the ;/ rays of an ultrasonic study of the all/bladder. #or no", do not eat reasy food. 1o not eat close to your sleep time because it could cause you more acidity. &at plain food, nothin spicy. As soon as I et the results from the medical test, I "ill tal( to you. 1o you have any
