Intermittent pain in abdomen and nausea

59/y/o male patient with intermittent pain in abdomen and nausea since 1 year. He recently had 1 episode of bloody vomiting. On Examination Thin & lean man Temp 98.8 F, RR 16/min, Pulse 110/min, BP 108/76 Skin examination- no rash or lesions. No palpable lymphnodes. HEENT - crusted blood on face and in oropharynx but without visible trauma or mucosal abnormalities TMs are normal. CHEST - clear. P/A soft nontender without hepatosplenomegaly; no ascites

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Rx Nux vomica 30 tds for one week Adv Endoscopy

Drakshadi kashayam Stop IBS Vilva gutika

Indukantham kashayam with vidangadi gulika on empty stomach Sharivasavam 30ml twice a day after ideal diet Takrarishtam at night

Thorough clinical examination n investigation is to be. made for treatment..

Radiological and Pathological investigations Needed.

? APD .. ? ENTERITIS.. ? INTESTINAL PATHOLOGY..

Suggest chest xray Usg abd.

Referred to endoscopy and CBC examination

Prostate Enlaged Test PSA level

Irritable bowel syndrome (IBS)

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