12. Symptoms of Ductal Ulcer

Duodenal ulcer is a common problem nowadays, which causes considerable harm to the human body. Therefore, after the occurrence of duodenal ulcer, it is necessary to choose the appropriate method to slowly adjust. Generally, patients will have very typical symptoms, which are problems with the digestive tract system, and may even cause hunger, obvious intestinal rumbling, and radiating pain. In normal times, it is necessary to choose the appropriate method according to the symptoms and slowly adjust.

Symptoms and signs 1. Typical manifestations The main symptoms of peptic ulcer are upper abdominal pain or indigestion. The pain is located to the right of the midline of the upper abdomen and is relatively localized. Patients often describe the pain as "gnawing" or "hunger-like." The pain has obvious rhythmicity and can be relieved by eating food or taking antacids. It often recurs 1 to 3 hours after a meal (food stimulates the continuous secretion of gastric acid for 3 to 4 hours, while food takes about 2 hours to completely empty from the stomach). Patients often wake up in pain during sleep between 1:00 and 3:00 a.m., especially those who eat snacks before going to bed. The pain may radiate to the right hypochondrium or right back. If there are no complications, radiating pain rarely occurs. Persistent back pain often indicates

Penetration of posterior wall ulcer.

Another major characteristic of ulcer pain is its cyclical nature, which means that it often recurs at intervals of weeks to months. During the exacerbation phase, abdominal pain often occurs every day, lasting for several weeks before resolving until the next recurrence. The disease usually occurs in late autumn and early spring. Since eating can often relieve pain, patients with duodenal disease often like to eat snacks and their weight is often slightly higher than normal people.

In patients with duodenal ulcer, if the abdominal pain is significantly aggravated and spreads to the entire abdomen, it often indicates that the ulcer has perforated. This is often followed by disappearance of bowel sounds and widespread rebound pain. Likewise, loss of a normal rhythm and a constant pain often indicates penetration.

Some patients with chronic duodenal ulcers may experience "water-brash", that is, the mouth is suddenly filled with clear, colorless, odorless liquid (such as saliva). This is different from gastroesophageal reflux, which causes gastric contents to flow into the mouth (gastric contents are colored and have a sour and bitter taste), and the two should not be confused. Gastroesophageal reflux symptoms such as acid reflux and heartburn are not uncommon in patients with ulcer disease, especially in those with varying degrees of gastric emptying disorders. However, heartburn is a manifestation of gastroesophageal reflux, not duodenal ulcer.

Physical examination generally shows no abnormalities. During acute ulcer attacks, mild tenderness in the upper abdomen may occur, and the tenderness point is often located 2.5 cm or more to the right of the middle of the upper abdomen. It is necessary to check for occult blood in the stool. If occult blood is found, further examination should be performed without delay.

2. Atypical manifestations Atypical cases are very common in patients with duodenal ulcer. In reality, “typical presentation” is seen in a minority of cases and is not a measure of severity. Therefore, it is not reliable to diagnose or differentiate duodenal ulcers based solely on medical history and physical examination. Many patients do not have clear abdominal pain, or the pain is vaguely localized. Patients may have no symptoms at all, or may only complain of "indigestion" or vague symptoms of indigestion. These symptoms are very nonspecific and most are not due to ulcers.