A 57-year-old Chinese man presented with abdominal bloating associated with flatulence and belching over a 4-month period, which was especially worse with the intake of fatty food. He had decreased appetite, with weight loss of approximately 4 kg during the same period.
He denied any fever, chills, nausea, or vomiting. There was no recent change in his bowel habits or caliber of stools. He claimed to have foul-smelling urine, but there was no complaint of dysuria. He had no complaints of cough or dyspnea. There was no history of inhalational exposure.