HPI: 72 year-old female with medication-controlled coronary artery disease and diabetes mellitus who presents with a complaint of abdominal discomfort of two months duration. She describes the discomfort as a crampy pain that she is unable to localize. The discomfort is worse after meals and Motrin or Maalox do not relieve the pain. She has also felt constipated over the same period of time for which she has taken Metamucil without benefit. When asked about any changes in her stools she replied that she hasnÕt looked at a bowel movement since her children got out of diapers. The only thing she has noticed to have changed is her skin is paler - possibly because she hasnÕt been out on her morning walks with friends because of her increasing fatigue. She states that the only good thing about all of this is that she has lost 15 pounds.

Social History: Smoked for 50 years but is down to 1/2 pack per day. Drinks a cocktail before dinner is served.

Family History: Positive for hypertension, heart disease, and diabetes mellitus in her sister and brother. No family history of gastrointestinal disorders.