[Verified Answer]: A 37-year-old executive returns to your…

A 37-year-old executive returns to your clinic for follow-up of recurrent upper abdominal pain. He had been experiencing a “burning” epigastric pain intermittently for more than 2 years but did not seek medical attention until recently, when the pain increased in frequency and severity over the past 2 months. The pain now occurs three to four times per week, is more noticeable “on an empty stomach,” and often awakens him at night. The pain is usually relieved immediately after eating or using over-the-counter antacids, but it recurs within 2 to 3 hours. He admits to experiencing increased stress at work, drinking more caffeine, and frequently eating take-out foods because of his busy schedule. His medical history and review of systems are otherwise unremarkable. He takes no medications besides the occasional use of antacids. His physical examination is normal, including a stool guaiac test, which was negative for occult blood. Results of the laboratory tests performed at his initial visit show no anemia, but his serum Helicobacter pylori antibody test is positive. What is the most likely diagnosis? What are the main risk factors for developing this condition? What is your next step?