An older adult presents with vague epigastric pain at night and early satiety after recent ibuprofen use. What is the most likely diagnosis?

In the context of an older adult experiencing vague epigastric pain at night and early satiety after recent ibuprofen use, the most likely diagnosis is a duodenal ulcer. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are well-known risk factors for the development of peptic ulcers due to their effect on gastric mucosal protection and intrinsic inhibition of prostaglandin synthesis.

Ulcers typically present with pain that may be alleviated by eating, yet provoke symptoms of discomfort, particularly at night when the stomach is empty. The early satiety contributes to this diagnosis, as it can indicate discomfort occurring from inflammation or ulceration in the gastroduodenal area. Additionally, duodenal ulcers often cause pain that is described as a burning sensation in the epigastric region, fitting the symptom profile presented.

While gastroparesis, reflux esophagitis, and Crohn's disease can also cause gastrointestinal symptoms, the specific combination of recent ibuprofen use, vague nighttime epigastric pain, and early satiety aligns most closely with the presentation of a duodenal ulcer. The route of inquiry into NSAID use and the considered timing and nature of symptoms reinforces the association with