A 40-year-old woman presents with a 6-month history of intermittent upper abdominal discomfort described as postprandial fullness and occasional epigastric pain. She denies weight loss or alarm symptoms.
She is otherwise well, but reports significant stress at work and a long-standing history of generalized anxiety disorder.
She does not take NSAIDs, smokes 10 cigarettes daily, and recently recovered from a self-limiting episode of bacterial gastroenteritis. H. pylori testing is pending.
Which of the following is the most likely explanation for her symptoms?
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