Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with persistent epigastric pain, early satiety, and unexplained weight loss. History significant for known systemic sarcoidosis. Symptoms are refractory to standard PPI therapy. No evidence of H. pylori infection or Crohn’s disease. Denies hematemesis or melena.
Clinical Examination Findings
Abdominal examination reveals mild epigastric tenderness without rebound or guarding. No palpable masses or organomegaly. Bowel sounds are normoactive. Extra-abdominal exam: check for lymphadenopathy, cutaneous sarcoid lesions, or pulmonary crackles consistent with systemic involvement.
Treatment Protocol
Initiate systemic corticosteroid therapy (e.g., Prednisone 0.5-1 mg/kg/day) with a gradual tapering schedule based on clinical response. Consider steroid-sparing agents (e.g., Azathioprine or Methotrexate) for refractory cases. Continue PPI therapy for symptomatic relief of gastric acid-related irritation. Monitor for potential side effects of long-term steroid use.