Sport, Testosterone, Reflux, PPI, fundoplication and therapy refracter chronic abdominal pain in the case of a young male

Case History: A male patient born in 1979 suffered from recidive epigastrial pain having need for several hospital admissions since 1997. In 1999 GERD was diagnosed after a pain relapse, when gastroparesis (T1/2=140min) was detected by scintigraphy. Since then a chronic proton pump inhibitor (PPI) maintenance therapy was introduced. In 2009 a persistent 2cm subcardiac erosive spot had been detected by gastroscopy, patohistology showed consequently parietal cell hyperplasia. Because of persistent symptoms, early morning pain, vomiting, then bettering during daytime, a systematic diagnostic approach followed and r…