Clinical features of a gastric ulcer

The clinical features of a gastric ulcer include:

• epigastric discomfort or pain:
  • may vary from a vague and mild discomfort, which is ignored, to a very severe pain that makes the patient lie down
  • the pain occurs 15 to 30 minutes after eating
  • the pain is relieved by vomiting and made worse by eating - thus these patients often complain of weight loss rather than the weight gain associated with duodenal ulcers - the patient may complain of being 'afraid to eat'
  • pain often worst during the day; pain is often worst during the night in duodenal ulceration
  • pain lasts for a period of about 2 weeks and occurs in cycles of every 1-2 months
    
    
• acidbrash, waterbrash and heartburn are symptoms common to both types of ulcer, but occur slightly more often in patients with duodenal ulcers.
  
  
• haematemesis and melaena may complicate all forms of peptic ulceration
  
  
• examination is likely to be normal. There is usually no more than mild to moderate epigastric tenderness.