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Clinical manifestations of peptic ulcer disease

Andrew H Soll, MD
Section Editor
Mark Feldman, MD, MACP, AGAF, FACG
Deputy Editor
Shilpa Grover, MD, MPH


Peptic ulcers may present with dyspeptic or other gastrointestinal symptoms or may be completely asymptomatic, sometimes until complications such as hemorrhage or perforation occur. The symptoms associated with peptic ulcers are not sensitive or specific and the differential diagnosis is broad. (See "Approach to the adult with dyspepsia".)

This topic will review the clinical manifestations of peptic ulcer disease and the differential diagnosis that should be considered. The methods used to establish the diagnosis, the association with H. pylori infection, and an approach to therapy are presented separately. (See "Epidemiology and etiology of peptic ulcer disease" and "Diagnosis of peptic ulcer disease" and "Overview of the natural history and treatment of peptic ulcer disease".)


The epidemiology of peptic ulcer disease is discussed separately. (See "Epidemiology and etiology of peptic ulcer disease".)


A pragmatic definition of "dyspepsia" is the presence of symptoms that the clinician suspects are coming from the upper gastrointestinal (GI) tract [1]. Peptic ulcers can present with any of the three dyspeptic symptom patterns:

  • Ulcer-like or acid dyspepsia (burning pain; epigastric hunger-like pain; relief with food, antacids, and/or antisecretory agents)
  • Food-provoked dyspepsia or indigestion (postprandial epigastric discomfort and fullness, belching, early satiety, nausea, and occasional vomiting)
  • Reflux-like dyspepsia


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Literature review current through: Mar 2015. | This topic last updated: Feb 15, 2013.
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