gastrointestinal disorders
Peptic Ulcer Disease
Symptoms and Signs of Peptic Ulcer Disease
Symptoms of peptic ulcer disease depend on ulcer location and patient age; many patients, particularly older patients, have few or no symptoms. Pain is most common, often localized to the epigastrium and relieved by food or antacids. The pain is described as burning or gnawing, or sometimes as a sensation of hunger. The course is usually chronic and recurrent. Only about half of patients present with the characteristic pattern of symptoms. Gastric ulcersymptoms often do not follow a consistent pattern (eg, eating sometimes exacerbates rather than relieves pain). This is especially true for pyloric channel ulcers, which are often associated with symptoms of obstruction (eg, bloating, nausea, vomiting) caused by edema and scarring. Duodenal ulcerstend to cause more consistent pain. Pain is absent when the patient awakens but appears mid-morning and is relieved by food but recurs 2 to 3 hours after a meal. Pain that awakens a patient at night is common and is highly suggestive of duodenal ulcer. In neonates, perforation and hemorrhage may be the first manifestation of duodenal ulcer. Hemorrhage may also be the first recognized sign in later infancy and early childhood, although repeated vomiting or evidence of abdominal pain may be a clue. 