A Daily Beer Drinker With Agonizing Gas and Back Pain

Erik D. Schraga, MD


February 09, 2021

Editor's Note:
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A 47-year-old man presents to the emergency department (ED) with a chief complaint of waking up with severe abdominal pain. He states that over the past week, he has had intermittent, gaslike epigastric pain and a sensation "like I need to burp." As of this morning, the pain has acutely worsened. It is now radiating in a bandlike pattern throughout the patient's upper abdomen and to his back. The pain is most intense when he lies flat on his back and seems to be slightly better when he sits upright.

The patient has mild nausea but has not vomited. He has not experienced any chills or fever, and he denies having any diarrhea. He did have one nonbloody bowel movement before coming to the ED. He reports no chest pain, shortness of breath, or palpitations. He drinks approximately 6-8 beers daily but says he has no chronic medical conditions and does not take any medications.

He denies using over-the-counter pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs). He does not have any medication allergies.


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