Comprehensive iHuman Case Study:
William Garrett – Duodenal Ulcer
Secondary to H. pylori and Chronic
NSAID Use in a 50-Year-Old Male.
**Patient:** Mr. William Garrett, 50-year-old male
**Chief Complaint:** Persistent epigastric burning pain for several months
**Setting:** Outpatient primary care clinic
Mr. Garrett presents with a multi-month history of non-radiating, gnawing,
burning epigastric abdominal pain. The pain follows a classic pattern—
exacerbated by an empty stomach (fasting) and temporarily relieved by food
ingestion (such as milk or bread) or over-the-counter antacids. He reports a
transient episode of dark, tarry stools and coffee-ground emesis approximately
two months prior, which spontaneously resolved.
, **Key History:**
- **Past Medical History:** Bilateral knee osteoarthritis, dyslipidemia
- **Medications:** Regular NSAID (ibuprofen) and aspirin use for knee pain
- **Social History:** 10 pack-year smoking history, moderate social alcohol
consumption
- **Allergies:** NKDA (No Known Drug Allergies)
**Vitals:**
- Temperature: 98.6°F
- Heart Rate: 76 bpm
- Blood Pressure: 128/82 mmHg
- Respiratory Rate: 16/min
- Height: 6'0" (183 cm)
- Weight: 170 lbs (77.3 kg)
- BMI: 23.1
---
## Subjective Data (History of Presenting Illness)
### Chief Complaint
> *"I've been having stomach pain and I just hit my breaking point. I'm hoping you
can figure out what is causing it and fix it."*
### Pain Characteristics
William Garrett – Duodenal Ulcer
Secondary to H. pylori and Chronic
NSAID Use in a 50-Year-Old Male.
**Patient:** Mr. William Garrett, 50-year-old male
**Chief Complaint:** Persistent epigastric burning pain for several months
**Setting:** Outpatient primary care clinic
Mr. Garrett presents with a multi-month history of non-radiating, gnawing,
burning epigastric abdominal pain. The pain follows a classic pattern—
exacerbated by an empty stomach (fasting) and temporarily relieved by food
ingestion (such as milk or bread) or over-the-counter antacids. He reports a
transient episode of dark, tarry stools and coffee-ground emesis approximately
two months prior, which spontaneously resolved.
, **Key History:**
- **Past Medical History:** Bilateral knee osteoarthritis, dyslipidemia
- **Medications:** Regular NSAID (ibuprofen) and aspirin use for knee pain
- **Social History:** 10 pack-year smoking history, moderate social alcohol
consumption
- **Allergies:** NKDA (No Known Drug Allergies)
**Vitals:**
- Temperature: 98.6°F
- Heart Rate: 76 bpm
- Blood Pressure: 128/82 mmHg
- Respiratory Rate: 16/min
- Height: 6'0" (183 cm)
- Weight: 170 lbs (77.3 kg)
- BMI: 23.1
---
## Subjective Data (History of Presenting Illness)
### Chief Complaint
> *"I've been having stomach pain and I just hit my breaking point. I'm hoping you
can figure out what is causing it and fix it."*
### Pain Characteristics
