A 42-year-old male experiences epigastric pain that improves after eating. What is the most likely diagnosis?

The presentation of epigastric pain that improves after eating is characteristic of a duodenal ulcer. This type of ulcer is located in the first part of the small intestine and is triggered by acid secretion. When the patient eats, food acts as a buffer and temporarily neutralizes gastric acid, leading to relief from the pain.

In contrast, gastric ulcers often cause pain that worsens after meals due to increased gastric acid production in response to food intake. Gastroesophageal reflux disease (GERD) generally presents with heartburn or regurgitation, which typically does not improve after eating. Cholecystitis, inflammation of the gallbladder, usually presents with pain after meals but is more associated with fatty meals and right upper quadrant pain rather than a consistent improvement with eating. Therefore, the symptom of improving epigastric pain after eating aligns most closely with a duodenal ulcer.