Peptic ulcer history and symptoms

Peptic ulcer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Peptic Ulcer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Upper GI Endoscopy
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery Endoscopic management Surgical management
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
2017 ACG Guidelines for Peptic Ulcer Disease
Guidelines for the Indications to Test for, and to Treat, H. pylori Infection
Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America
Guidlines for factors that predict the successful eradication when treating H. pylori infection
Guidelines to document H. pylori antimicrobial resistance in the North America
Guidelines for evaluation and testing of H. pylori antibiotic resistance
Guidelines for when to test for treatment success after H. pylori eradication therapy
Guidelines for penicillin allergy in patients with H. pylori infection
Guidelines for the salvage therapy
Peptic ulcer history and symptoms On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Peptic ulcer history and symptoms All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Peptic ulcer history and symptoms
CDC on Peptic ulcer history and symptoms
Peptic ulcer history and symptoms in the news
Blogs on Peptic ulcer history and symptoms
to Hospitals Treating Peptic ulcer
Risk calculators and risk factors for Peptic ulcer history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  :Manpreet Kaur, MD [2]

Overview

The hallmark of peptic ulcer disease is an episodic epigastric pain which cause awakening at night. A positive history of epigastric pain, use of drugs like NSAIDs including aspirin which inhibit cyclooxygenase, use of antiplatelets,steroids and family history of peptic ulcer disease is suggestive of peptic ulcer disease. The most common symptoms of peptic ulcer disease include episodic epigastric pain, heartburn, loss of appettite, gastroesophageal reflux, waterbrash, hematemesis and melena. Less common symptoms of peptic ulcer disease include intolerance to fatty food.

History

Obtaining the history is the most important aspect of making a diagnosis of peptic ulcer disease. It provides insight into the cause, precipitating factors and associated comorbid conditions.

Past Medical History

• A history of epigastric pain, dyspepsia, or prior peptic ulcer may suggest the diagnosis of peptic ulcer disease.

Medication History

• Prior use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) is important because these patients have an increased risk of gastric ulcer and a fourfold risk of significant GI bleeding compared with other patients

Social History

• Helicobacter pylori infection is more common in low socioeconomic status and increased number of siblings
• Alcoholics also frequently have peptic ulcers or gastritis
• Cigarette smokers have a significantly higher rate of the recurrent duodenal ulcer as compared with nonsmokers

Family History

• Family history of peptic ulcer disease increases the risk of peptic ulcer
• History of peptic ulcer disease in mother increases the risk of peptic ulcer disease in children

Symptoms

• The majority of patients with the peptic ulcer disease are symptomatic but some people do not show any symptoms,called as a silent ulcer.
• The hallmark of peptic ulcer disease:
  • Episodic gnawing or burning epigastric pain which occurs one to five hours after meals or on an empty stomach
  • Nocturnal pain relieved by food intake, antacids, or antisecretory agents
  • Chronic use of NSAIDs

Difference in symptoms of gastric and duodenal ulcer
	Gastric ulcer	Duodenal ulcer
Epigastric pain	Occurs 1-2 hours after eating	Occurs 2-5 hours after eating
	Increases with eating	Decreases with eating
	Pain at night is less common	Pain at night is more common
Heartburn, chest discomfort and early satiety	Occurs commonly	Less commonly occurs
Bleeding presentation	Melena Hematemesis	Melena Hematochezia

Common Symptoms

Common symptoms of peptic ulcer disease include:

• Episodic epigastric pain
• Heartburn
• Bloating
• Nausea and vomiting
• Waterbrash
• Indigestion
• Hematemesis
• Melena
• Loss of appetite

Less Common Symptoms

Less common symptoms of peptic ulcer disease include:

• Intolerance to fatty food