Clinical features of peptic ulcers

Clinical features of peptic ulcers

The clinical features of gastric and duodenal ulceration cannot be di ff erentiated on the basis of symptoms. The demographic characteristics of groups of patients with gastric and duodenal ulceration do di ff er but this does not allow discrimination. Pain Epigastric pain, often described as gnawing and sometimes radiating to the back, is characteristic. Eating may sometimes relieve the discomfort. The pain is normally intermittent rather than intractable. Symptoms may disappear for weeks or months only to return again. This periodicity may be related to the spontaneous healing of the ulcer. Vomiting While this occurs, it is not a notable feature unless stenosis has occurred. Alteration in weight Weight loss or, sometimes, weight gain may occur. Patients with gastric ulceration are often underweight but this may precede occurrence of the ulcer. Bleeding Bleeding may be chronic and presentation with microcytic anaemia is not uncommon. All such patients should be investigated with endoscopy . Acute presentation with Christian Albert Theodor Billroth , 1829–1894, Professor of Surgery , Vienna, Austria. and melaena .