Review Question - QID 214688

A 43-year-old man presents to the office for worsening heartburn and abdominal pain for the past 8 months. Additionally, he has lost 10 lbs over the past year and has occasionally vomited small amounts of blood. He has trialed several antacids including pantoprazole and ranitidine with little relief. He denies any smoking, alcohol, or drug use. His father has a similar history of heartburn as well as hyperparathyroidism. On physical examination, he has marked epigastric tenderness without rebound or guarding. An upper endoscopy reveals multiple ulcers in the distal duodenum. Biopsies from these ulcers are negative for Helicobacter pylori. Given the most likely diagnosis, what other symptom is this patient most likely to experience?