Peptic ulcer history and symptoms: Difference between revisions
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Revision as of 20:21, 16 November 2017
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Peptic ulcer Microchapters |
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2017 ACG Guidelines for Peptic Ulcer Disease |
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Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
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Guidlines for factors that predict the successful eradication when treating H. pylori infection |
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Guidelines to document H. pylori antimicrobial resistance in the North America |
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Peptic ulcer history and symptoms On the Web |
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American Roentgen Ray Society Images of Peptic ulcer history and symptoms |
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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
History and Symptoms
Symptoms of a peptic ulcer can be:
- Abdominal pain, classically epigastric with severity relating to mealtimes, after around 3 hours of taking a meal (duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it);
- Bloating and abdominal fullness
- Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus)
- Nausea, and lots of vomiting
- Loss of appetite and weight loss;
- Hematemesis (vomiting of blood); if the blood is just streaks, then the esophagus probably got hurt from all the vomitting.
- Melena (tarry, foul-smelling faeces due to oxidized iron from hemoglobin)
- Rarely, an ulcer can lead to a gastric or duodenal perforation. This is extremely painful and requires immediate surgery.
A history of heartburn, gastroesophageal reflux disease (GERD) and use of certain forms of medication can raise the suspicion for peptic ulcer. Medicines associated with peptic ulcer include NSAID (non-steroid anti-inflammatory drugs) that inhibit cyclooxygenase, and most glucocorticoids (e.g. dexamethasone and prednisolone).
In patients over 45 with more than 2 weeks of the above symptoms, the odds for peptic ulceration are high enough to warrant rapid investigation by EGD (see below).
The timing of the symptoms in relation to the meal may differentiate between gastric and duodenal ulcers: A gastric ulcer would give epigastric pain during the meal, as gastric acid is secreted, or after the meal, as the alkaline duodenal contents reflux into the stomach. Symptoms of duodenal ulcers would manifest mostly before the meal — when acid (production stimulated by hunger) is passed into the duodenum. However, this is not a reliable sign in clinical practice.
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,,intolerance to fatty food , gastroesophageal reflux,waterbrash,. Less common symptoms of peptic ulcer disease include hematemesis and melena.[1][2]
History and Symptoms
- The majority of patients with the peptic ulcer disease are symptomatic but some people donot show any symptoms,called as a silent ulcer.
- The hallmark of peptic ulcer disease :
- Episodic gnawing or burning epigastric pain which occurs two to five hours after meals or on an empty stomach
- Nocturnal pain relieved by food intake, antacids, or antisecretory agents[1].
Positive history :
- Episodic epigastric pain
- Use of NSAIDs twice or thrice a day
- Family history of peptic ulcer disease
History
Patients with peptic ulcer disease may have a positive history of:
- Episodic epigastric pain
- Daily Use of NSAIDs
- positive family history
Common Symptoms
Less Common Symptoms
References
- ↑ 1.0 1.1 Ramakrishnan K, Salinas RC (2007). "Peptic ulcer disease". Am Fam Physician. 76 (7): 1005–12. PMID 17956071.
- ↑ Drini M (2017). "Peptic ulcer disease and non-steroidal anti-inflammatory drugs". Aust Prescr. 40 (3): 91–93. doi:10.18773/austprescr.2017.037. PMC 5478398. PMID 28798512.