Final answer:
The workup for mid-epigastric pain worsened by eating, with a history of NSAID or steroid use, should focus on gastrointestinal causes like ulcers and include laboratory tests and endoscopy. Treatment involves avoiding the offending drugs, using acid-reducing medication, and possibly antibiotics for confirmed ulcers.
Step-by-step explanation:
The question pertains to mid-epigastric pain that worsens with eating and a history of NSAID and/or steroid use. In such a scenario, a gastrointestinal issue such as an ulcer or gastritis is possible. The workup should include a detailed history and physical examination, focusing on the pain characteristics, duration, and associated symptoms. Tests like complete blood count (CBC), liver function tests (LFT), serum amylase, and lipase may be ordered to rule out other conditions. An upper endoscopy (esophagogastroduodenoscopy or EGD) is also an important diagnostic tool to directly visualize the esophagus, stomach, and duodenum for any ulcers or erosions.
Treatment (txt) should involve cessation of NSAID and/or steroid use if possible, with the introduction of proton pump inhibitors (PPIs) or H2 receptor blockers to reduce stomach acid production and promote healing. In cases of confirmed peptic ulcer disease, especially if Helicobacter pylori infection is present, appropriate antibiotic therapy may be needed. It's important to monitor the response to treatment and look out for potential complications such as bleeding or perforation.