Peptic Ulcer Disease III: Clinical Manifestations and Complications

Peptic ulcer disease, or PUD, includes both gastric and duodenal ulcers, which present with epigastric pain but may differ in timing and associated features.

Gastric ulcer pain usually begins shortly after eating and may be worsened by food intake.

This can result in early satiety, anorexia, weight loss, and often nausea or vomiting.

However, duodenal ulcer pain typically develops 2 to 3 hours after meals or during the night and may be relieved by food or antacids, a pattern known as “pain–food–relief.

Major complications of PUD include the following.

Bleeding, which can develop in both gastric and duodenal ulcers, may present as vomiting blood, called hematemesis, or as black, tarry stools, known as melena.

Perforation involves full-thickness erosion of the gastric or duodenal wall, leading to peritonitis and severe abdominal pain.

Gastric outlet obstruction results from chronic inflammation or scarring and causes abdominal bloating, vomiting of undigested food, and decreased appetite.