A 35yo man presents with hx of dyspepsia. H.Pylori antibodies are negative. No improvement is
seen after 1m of tx. What is the next step?
a. Urea breath test
b. Gastroscopy
c. CT
d. MRI
Q. 1. What is the key?
Q. 2. What may be the D/D here?
Q. 3. At this age what are the indications of this procedure?
Ans. 1. Gastroscopy.
Ans. 2. Not responding to treatment D/D is: i) Jollinger Elison syndrome ii) Ca stomach
Ans. 3. Indications of gastroscopy in a 35 yo man (for man of age <50): i) Acute symptoms with H/O
previous episode (PUD) ii) Alarm features [weight loss, anaemia, vomiting, hematemesis and melaena,
dysphagia, palpable abdominal mass], fear of cancer, evidence of organic disease.