Chief Complaint: Mary is a 46-year-old female who was last seen in this office 2 years ago. She is complaining of abdominal pain. This pain is different from abdominal pain that she has suffered one year ago. Her pain is sharp and stabbing, though still located in the mid- epigastrium. The pain occurs about 45 minutes after eating and lasts less than one hour. The pain occasionally radiates over right shoulder. She notes that the pain is worse after her favorite meal, pizza. Physical Examination: she is a thin white female, appearing her stated age, weight hundred and 25 pounds, blood pressure 110/60 7 mmHg s

Abdominal pain can be due to several reasons, some of them are not so serious and self-limited only arising from eating something or some viral health issues. The pain lasts for a few seconds to minutes. Major cause being acidity which can be controlled by an antacid and with a check on food patterns.

As in the case of Mary who has been complaining of more severe abdominal pain, that is sharp and occurs in mid epigastrium which is the mid-upper abdomen.

And this pain occurs after her favorite meals, there can be several underlying possibilities to this.

It can gastritis (inflammation of stomach lining) and it can be due to infections, acid or alcohols and symptoms include; heartburn, nausea, and aching or burning pain.

Peptic Ulcers, gastroparesis and pancreatitis in all these disorders have nausea, worsening pain radiating to back or shoulders and pain lasts longer after having certain meals.

Mary needs to have medical attention immediately so that it does not progress further and cause any serious health issue.