You look at your schedule to see that your next patient, Mic…

You look at your schedule to see that your next patient, Michael, is a 40-year-old with complaints of “abdominal pain”. He is new to your practice. You enter the exam room to find him leaning with his arms over the exam room table. “It’s the only way I can get this pain to feel any better. My gut hurts so bad! Forget laying down at night, I can’t do it. I’ve been going to sleep in the recliner, but now I can’t even lean back. I have to rest sitting up with my elbows on my knees.” What do you suspect is going on with Michael?