Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • 'pointing sign'

Other diagnostic factors

  • epigastric tenderness
  • nausea or vomiting
  • early satiety
  • weight loss or anorexia
  • diarrhoea
  • symptoms of anaemia
  • GI bleeding
  • shock
  • succussion splash

Risk factors

  • Helicobacter pylori infection
  • non-steroidal anti-inflammatory drug (NSAID) use
  • smoking
  • ABO blood group
  • increasing age
  • history (or family history) of peptic ulcer disease
  • patient in intensive care
  • alcohol
  • psychological stress

Diagnostic investigations

1st investigations to order

  • Helicobacter pylori breath test or stool antigen test
  • upper gastrointestinal endoscopy
  • FBC
  • stool heme test
Full details

Investigations to consider

  • fasting serum gastrin level
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor of Clinical Medicine

Program Director Gastroenterology Fellowship Program

Department of Internal Medicine

Wexner Medical Center

Columbus

OH

Disclosures

MMM declares that he has no competing interests.

Dr Marty M. Meyer would like to gratefully acknowledge Dr Steven Moss, a previous contributor to this monograph. SM is on the speaker's bureau for Otsuka, the manufacturer of Helicobacter pylori breath-test kits.

Peer reviewers VIEW ALL

Professor of Medicine

Department of Gastroenterology and Hepatology

Cleveland Clinic

Cleveland

OH

Disclosures

GF declares that he has no competing interests.

Consultant

Gastrounit Medical Division

Copenhagen University Hospital Hvidovre

Copenhagen

Denmark

Disclosures

LLG declares that she has no competing interests.

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