ROSH Gastrointestinal Practice Exam

Which gastrointestinal condition is known for causing progressive abdominal pain during the night?

1. Gastroesophageal reflux disease

2. Irritable bowel syndrome

3. Peptic ulcer disease

4. Diverticulitis

The correct answer is: Peptic ulcer disease

Peptic ulcer disease is characterized by the presence of ulcers in the stomach or the duodenum, and it is known for causing progressive abdominal pain, especially during the night. This is often due to the increased secretion of gastric acid while the individual is lying down, which can exacerbate pain associated with ulcers. Patients frequently report that their pain occurs in cycles and may be relieved by food or antacids, but it can also worsen when the stomach is empty, a scenario common during nighttime. In contrast, gastroesophageal reflux disease primarily presents with symptoms like heartburn and regurgitation, which can also worsen at night but are not specifically tied to progressive abdominal pain. Irritable bowel syndrome is often associated with fluctuations in bowel habits, abdominal discomfort, and bloating rather than consistent night-time pain. Diverticulitis typically presents with left lower quadrant pain and is more associated with changes in bowel habits rather than progressive pain during the night. Understanding these distinctions helps elucidate why peptic ulcer disease is correctly identified as the condition that commonly causes progressive abdominal pain during the night.