Your patient complains of chronic "burning" stomach pain that improves after eating. You should suspect:

• A. Aortic aneurysm
• B. Peptic ulcer disease
• C. Pneumonia
• D. Kidney stones

Answer: (B)

Recognizing how pain relates to meals helps distinguish peptic ulcer disease from other abdominal problems. Burning epigastric pain that improves after eating is a classic sign of a duodenal ulcer, a form of peptic ulcer disease. The mechanism is that food can buffer stomach acid and temporarily reduce irritation of a duodenal ulcer, so the pain eases after a meal. This pattern is more typical for ulcers in the duodenum (peptic ulcers), whereas gastric ulcers often worsen with meals.

Most peptic ulcers arise from Helicobacter pylori infection or NSAID use, which explains why this symptom pattern points to PUD rather than other conditions.

Other options don’t fit the meal-relief pattern: an aortic aneurysm typically causes abrupt, severe back or chest-abdominal pain not tied to meals; pneumonia presents with cough and respiratory symptoms; kidney stones cause intense, episodic flank pain often with hematuria.