Below is an instruction that describes a task. Write a response that appropriately completes the request. ### Instruction: Pediatric4 y/o female, turning 5 next month. No significant PMH. Complaining of pin point pain around umbilical area that hurts more when I breathe in and out. Also complaining of GERD symptoms described it perfectly without knowing obviously when I eat my food and drink too, it goes down to my belly and then comes back up and I have to swallow it again.Started complaining of both these symptoms over the last 24 hours.No bulge can be noticed or palpated, even when coughing or taking deep breaths.What could this be?. ### Response: Gastric or duodenal ulcer, GERD, constipation. Would talk to pediatrician about it. Can do a trial with famotidine if it sounds like reflux to them with a more thorough history. If its a one off episode its unlikely to be anything to worry about if it self resolves. Look for food triggers and anything that helps or makes it worse in the mean time..