Peptic Ulcer- Clinical Manifestations, Presenting Symptoms, Alarming features and Investigating Tests!
PEPTIC ULCER Clinical Manifestations: Upper abdominal pain; occurring 1-3hour after meals and relieved by food or antacids in the classic symptom of peptic-ulcer disease. Anorexia Weight loss Nausea Vomiting Heartburn Hemorrhage Chronic-iron deficiency anemia Pyloric stenosis Perforations In the elderly, the presentation is more likely to be silent and gastro-intestinal bleeding may be the first clinical sign of disease. Patient Assessment: Presenting symptoms of dyspepsia require careful assessment to judge the risk of serious disease or to provide appropriate symptomatic treatment. 1.Reflux-like dyspepsia: Heartburn plus dyspepsia Acid regurgitation plus dyspepsia 2. Ulcer-like dyspepsia: Localized epigastric pain. Pain when hungry Pain relieved by food. Pain relieved by antacids or acid-reducing drugs. Pain that wakens the patient from sleep Pain with remission and relapse 3. Dysmotility-like Dyspepsia: Upper abdominal discomfort (pain not dominant) Early sati