system: You are a clinical documentation assistant. Generate only the requested clinical note section using only facts from the dialogue. Do not invent information. If the section is not supported by the dialogue, return N/A.

user: Section: GENHX

Dialogue:
Doctor: Hi, the weather outside is beautiful, did you get some sunshine?
Patient: Yes in fact I came in walking.
Doctor: Great way to get some exercise in.
Doctor: ok so what's going on?
Patient: I am having a bellyache.
Doctor: Since when?
Patient: Oh, it's been a while now.
Doctor: Can you tell me more about your pain like how did it start and what exactly are you feeling?
Patient: Ok so the pain started as dullache but it is constant right here in the middle upper part of my stomach. And sometimes it is moving to the back.
Doctor: Can you tell me if it is stabbing pain and if it is related to any specific time of the day?
Patient: Sure, so i do get episodes of stabbing pain but they are not related to meals. Once the wave comes it lasts for only a minute or so.
Doctor: Can you tell me when exactly you noted it?
Patient: Approximately six months back. I took over the counter antacids and got some relief so i did not go to doctor. But two months back it got worse, I do get occasional nausea and vomiting.
Doctor: I can see that they found H pylori positive infection and treated you with triple drug therapy for two weeks and then gave you antacid omeprazole. But it did not improve your pain.
Patient: Yeah that's right.
Patient: Do you know I lost twenty pound of weight since all these symptoms began but i have been also admitted for poor appetite.
Doctor: Ok tell me how are your bowel movements and if you see any blood in stools?
Patient: I get two to three loose bowel movements a day but no blood in stool or anywhere.
Doctor: Are you taking any pain medication over the counter? Do you drink alcohol and maybe you are vomiting blood?
Patient: No no, nothing like that.
Doctor: Can you tell me if any change in position changes the quality of pain? do you have any fever?
Patient: No position changing have no effect, no fever or anything.
Doctor: Have you been exercising before all this?
Patient: Yes I have had very active and healthy lifestyle.

assistant: 23-year-old Hispanic male who presented for evaluation of chronic abdominal pain. Patient described the pain as dull, achy, constant and located at the epigastric area with some radiation to the back. There are also occasional episodes of stabbing epigastric pain unrelated to meals lasting only minutes. Patient noted that the pain started approximately six months prior to this presentation. He self medicated "with over the counter" antacids and obtained some relief so he did not seek medical attention at that time. Two months prior to current presentation, he had worsening of his pain as well as occasional nausea and vomiting. At this time the patient was found to be H. pylori positive by serology and was treated with triple therapy for two weeks and continued on omeprazole without relief of his pain. The patient felt he had experienced a twenty-pound weight loss since his symptoms began but he also admitted to poor appetite. He stated that he had two to three loose bowel movements a day but denied melena or bright red blood per rectum. Patient denied NSAID use, ethanol abuse or hematemesis. Position did not affect the quality of the pain. Patient denied fever or flushing. He stated he was a very active and healthy individual prior to these recent problems.