Common Stomach Ulcer Symptoms

Pain
Epigastric pain (dyspepsia), is present in 80-90% of patients. However, this complaint is not sensitive nor specific enough to serve as a reliable diagnostic criterion for peptic ulcer disease. The clinical history cannot distinguish duodenal from stomach ulcers accurately. Less than 1/4 of patients with dyspepsia have ulcer disease at endoscopy. In patients with NSAID-induced ulcers, up to half are asymptomatic.

Pain is typically well localized to the epigastric region and is not severe. It is usually described as gnawing, dull, aching, or “hunger-like”. Typical features of stomach ulcer pain are rhythmicity and periodicity. Rhythmicity means that the pain fluctuates in intensity throughout the day and night. Half of patients report relief of pain with food or antacids (especially duodenal ulcers) and a recurrence of pain 2-4 hours later. 2/3 of duodenal ulcers and 1/3 of stomach ulcers cause nocturnal pain that awakens the patient.

A change from a patient’s typical rhythmic discomfort to constant or radiating pain may reflect ulcer penetration or perforation. Most patients have symptomatic periods lasting up to several weeks with intervals of months to years in which they are pain-free (periodicity).

Other stomach ulcer symptoms
Nausea and anorexia may occur with gastric ulcers. Significant vomiting and weight loss are unusual with uncomplicated ulcer disease and suggest gastric outlet obstruction or gastric malignancy.

Physical findings
The physical examination is often unremarkable in uncomplicated peptic ulcer disease. Mild, localized epigastric tenderness to deep palpation may be present. Fecal occult blood testing is positive in one-third of patients.

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