Risk Factors

• Advanced Age • Possible risk factors

– H. Pylori infection
• History of ulcers
– Cigarette smoking
• Concomitant – Alcohol consumption
Glucocorticoid use
• Concomitant
Anticoagulant
• High dose NSAIDs
• Multiple NSAIDs
• Multisystem/Serious
disease
 Clinical Features
• Pain is often absent
• If present, Epigastric pain
– Burning, Gnawing
– Relieved by antacids

Duodenal Ulcer Gastric Ulcer

Relieved by food Precipitated by food
1 ½ - 3 h after a meal Nausea, Weight loss
Awakens patients from sleep
 Clinical Features
• Complication (10%)
– Bleeding
• Tarry Stools, Coffee ground emesis
– Perforation
• Sudden, generalized abdominal pain
– Obstruction
• Pain that worsens after meal + Nausea + Vomiting
 PE Findings
• Often normal if uncomplicated
• Epigastric tenderness, 20% right of midline
• Complication related findings
– Tachycardia
– Orthostasis
– Boardlike Abdomen
– Succusion splash