Instructions
You are a medical student on placement in general practice. Your next patient is Jasmine Ooi, 34, an accountant, back for the results of the gastroscopy and blood tests arranged for her indigestion. Her notes and results are below.
Explain the diagnosis and your management plan to the patient
- You do not need to examine the patient.
- You do not need to write a prescription.
From the referral (six weeks ago)
Eight months of fullness after meals, unable to finish a normal meal, and upper abdominal discomfort, most days. No weight loss, vomiting, bleeding, black stools or trouble swallowing. Abdominal examination normal. Mother died of stomach cancer. No acid-suppressing tablets before the scope.
Gastroscopy (two weeks ago)
Oesophagus, stomach and duodenum normal. No ulcer, inflammation, narrowing or mass.
Biopsies
Stomach: normal lining; no Helicobacter pylori; no precancerous change or cancer. Duodenum: normal; no features of coeliac disease.
Blood tests (six weeks ago)
Full blood count, iron studies, kidney and liver function and CRP normal. Coeliac serology negative with a normal total IgA.
Gastroenterologist's letter
No structural cause found. Her symptoms fit functional dyspepsia (postprandial distress type). Please manage in general practice; happy to see her again if alarm features develop.