Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath and chest pain. major surgical or invasive procedure: esophagogastroduodenoscopy stomach antral biopsy x1 duodenal biopsy x1 history of present illness: pt is a 50 yo male with history of htn and dyslipidemia admitted on with significant anemia and suspected upper gi bleed. in , pt began taking naproxen 250 mg po bid for joint pain (took this for 45 days). late he began experiencing chest pain, doe, was feeling increasingly tired, and had orthostatic symptoms (was feeling dizzy when he arose to urinate at night). he presented to an osh, where he was found to be anemic, and an egd found a duodenal vs. gastric ulcer. he was given 2u of blood, was discharged on pantoprazole, and discontinued his naproxen. 2 days after his discharge, he again began experiencing doe, chest pain, was increasingly fatigued and had 2 near syncopal episodes. . on review of systems, pt states that he has had frequent diarrhea for the past 10-20 years. he states he has noticed his stool has been black for the past year or so, and that the frequency of his diarrhea has increased to 6 bm's in the morning over the past month or so. of note, he did have one episode of melena 3 days ago. he has not had a bm in the past 2 days. he denies n/v, though is having some mild epigastric discomfort. he has been able to ambulate around his room, and is currently not complaining of cp, sob, or dizziness. pt denies recent weight loss, fevers, or chills past medical history: -htn -dyslipidemia -depression -pud: patient states that he has had gnawing epigastric pain for years, and that it is decreased with meals (worse on an empty stomach). recent egd at osh in late showed ?gastric vs. duodenal ulcer (osh records not immediately available) social history: pt has lived in the past in the phillipines and in , though denies any past h. pylori testing. has smoked in the past, but is a current non-smoker. drank quite extensively while living in the phillipines, however currently drinks only socially. is recently divorced, and raising 6 y/o son alone (with help of his sister and mother). family history: father died in early 40s of mi, mother is in good health. has 3 siblings, all of whom have htn and dyslipidemia. no family history of gastric or duodenal ulcers. physical exam: vitals: t 97.1 bp 127/77 hr 75 rr 16 o2sat 99ra gen: well appearing, lying in bed, appropriate heent: nc/at, perrl, op clear, mmm neck: supple, no lad lungs: ctab, no wheezes or crackles heart: rrr, s1/s2 present, -mrg abd: +bs, soft, mildly tender in the epigastrium without rebound or guarding ext: no lower extremity edema neuro: aox3, 5/5 strength in all 4 ext pertinent results: 12:40pm blood ctropnt-<0.01 12:40pm blood ck-mb-2 12:40pm blood wbc-6.3 rbc-2.89* hgb-6.8* hct-21.7* mcv-75* mch-23.6* mchc-31.4 rdw-17.6* plt ct-311 05:19pm blood hct-19.3* 06:04pm blood hct-19.7* 10:11pm blood hct-18.8* 11:17pm blood hct-21.7* 04:56am blood wbc-5.0 rbc-3.10* hgb-7.6* hct-23.2* mcv-75* mch-24.5* mchc-32.6 rdw-16.3* plt ct-242 01:22pm blood wbc-6.4 rbc-3.50* hgb-9.3* hct-26.8* mcv-77* mch-26.5* mchc-34.7 rdw-17.5* plt ct-290 09:49pm blood hct-27.5* 05:15am blood wbc-6.6 rbc-3.67* hgb-9.8* hct-28.6* mcv-78* mch-26.7* mchc-34.2 rdw-17.5* plt ct-264 12:40pm blood hypochr-3+ anisocy-1+ poiklo-3+ macrocy-normal microcy-3+ polychr-1+ ovalocy-2+ schisto-1+ tear dr1+ 12:40pm blood glucose-97 urean-19 creat-0.9 na-138 k-3.9 cl-104 hco3-23 angap-15 04:56am blood glucose-88 urean-16 creat-0.9 na-139 k-3.9 cl-109* hco3-20* angap-14 05:15am blood glucose-72 urean-15 creat-1.0 na-139 k-4.3 cl-107 hco3-20* angap-16 04:56am blood ld(ldh)-144 totbili-1.3 dirbili-0.3 indbili-1.0 05:15am blood albumin-3.8 calcium-7.8* phos-2.9 mg-2.0 -h. pylori antibody test: negative -tissue transglutaminase: pending at time of discharge . imaging/studies: ekg: sinus rhythm. modest inferior and anterolateral lead t wave changes are non-specific. no previous tracing available for comparison. . cxr: the cardiomediastinal contours are within normal limits. there is no focal consolidation, effusion or pneumothorax. the right costophrenic angle is excluded from the film. there is no definite evidence of free air below the diaphragm. impression: no acute cardiopulmonary process. . egd: findings: esophagus: normal esophagus. stomach: mucosa: erythema, congestion and erosion of the mucosa were noted in the antrum. cold forceps biopsies were performed to assess for h. pylori at the stomach antrum. duodenum: mucosa: question minimal scalloping folds of the mucosa was noted in the second part of the duodenum. cold forceps biopsies were performed to assess for celiac disease at the second part of the duodenum. impression: question minimal scalloping folds in the second part of the duodenum (biopsy) erythema, congestion and erosion in the antrum (biopsy). otherwise normal egd to third part of the duodenum. brief hospital course: pt presented to the ed on with 2 near syncopal episodes, doe and non-radiating chest pain, with initial cardiac enzymes negative x1 and an initial hct of 21. .. # shortness of breath: pt initially presented with non-radiating chest pain and dyspnea on exertion. cardiac enzymes were negative x1. cxr was normal. ekg in icu was unremarkable. on discharge pt was no longer complaining of sob, and was able to ambulate without difficulty. . anemia: pt's initial hct in the ed was found to be 21. an ngt was subsequently placed, and showed brb which cleared with lavage. he received 4 units of blood, and his hct continued to trend upwards. pt was initially sent to the icu given concern of bright pink blood via ngt, however he remained hemodynamically stable in the icu, with an unremarkable ekg. gi was consulted and felt his bleed was most consistent with an ugi bleed given bright red lavaged on ngt, however given pt did experience one episode of melena 3 days prior, a lower gi bleed could not be excluded. gi recommended an inpatient egd and outpatient colonoscopy. an egd was performed and showed erosive gastritis with scalloping folds of the duodenal mucosa. biopsies were taken with results pending at the time of discharge. hpylori antibody testing was negative and tissue transglutaminase results were pending at the time of discharge. on discharge pt was able to eat and hct remained stable at 28.6 after having received 4 units of blood. he does need to have an outpatient colonoscopy within 1-2 weeks to rule out a lower gi source of his bleeding (which pt will call to schedule). pt was advised to have his hemoglobin and hct rechecked in a week (wednesday ) and have these results sent to his pcp (dr. . finally, enalapril was held during hospitilization and pt was discontinued on this medication, and advised to follow-up with this medication in discussion with his pcp. medications on admission: -omeprazole 40mg -simvastatin 20mg daily -enalapril 20mg daily -mirtazapine 30 mg po qhs discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. mirtazapine 15 mg tablet sig: two (2) tablet po hs (at bedtime). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po bid (2 times a day). 4. outpatient lab work please have your hemoglobin and hematocrit checked next wednesday, . please have these results faxed to dr. . discharge disposition: home discharge diagnosis: erosive gastritis duodenal scalloping discharge condition: alert. no acute distress. ambulating without difficulty. discharge instructions: you were admitted to the hospital with shortness of breath, chest pain, and found to have anemia. given your history of known gi bleeding it was suspected that you once again had upper gi bleeding. you were transfused 4 units of blood and underwent a esophagogastroduodenoscopy. this procedure showed inflammation of your stomach and a scalloped duodenum. stomach and duodenal biopsies were taken but the results will not be back for a week. you will need to call dr. office at to receive these biopsy results. you will need to have a colonoscopy performed within 1-2 weeks. please call dr. office to schedule this procedure. you will need to have a blood count checked next wednesday with the results faxed to dr. office. if you experience any further black or bloody stool you must call dr. . please stop taking enalipril. please speak with dr. before you restart this medicaiton. followup instructions: you will need to have a colonoscopy performed within 1-2 weeks. please call dr. office at to schedule this procedure. you will need to follow-up with dr. in weeks to check your blood pressure and to decide whether to restart the enalipril. procedure: esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: unspecified essential hypertension iron deficiency anemia secondary to blood loss (chronic) depressive disorder, not elsewhere classified other and unspecified hyperlipidemia family history of ischemic heart disease peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction other specified gastritis, with hemorrhage antirheumatics [antiphlogistics] causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to