Both gastric ulcers and duodenal ulcers are characterized by cramping, pressing, dull, pinching or stabbing pain in the upper abdomen, often radiating to the left side of the body. Often, the pain is directly related to food intake.The ulcers are located in typical sites: either at the small curve of the stomach or at the stomach outlet, in the stomach portal or in the initial part of the duodenum. In gastric ulcer, the pain disappears for a few hours after eating.
Pain during the night
In ulcers, pain during the night is also not uncommon:
- As hunger pains, which are especially apparent when the stomach is empty, typical of duodenal ulcer
- As an early pain, which occurs especially immediately following food intake, typical of ulcers in the body of the stomach.
- As late pain, which occurs most strongly one to three hours after eating, predominantly in ulcers of the gastric portal and in its immediate vicinity
Pain not necessarily a symptom
Both ulcer diseases can remain undetected for a long time, because the symptoms are not clear. Pain may also be absent altogether in many ulcer patients. Because of repeated small oozing bleeds from a duodenal or ventricular ulcer, anemia with general lassitude and pale skin color may be present.
More severe bleeding manifests as tarry stools. This is all-black, sticky stool. In addition, this bleeding can also lead to pronounced vomiting of blood (hematemesis). In such cases, a life-threatening situation can develop relatively quickly for the patient due to hemorrhage shock.
Bleeding as a sign of ulceration
Beyond bleeding, if the intestinal or gastric wall is breached, the stomach or intestinal contents enter the peritoneal cavity, which in turn becomes inflamed. In addition to peritonitis, the result is an acute abdomen (acute abdomen) and a paralytic ileus (paralytic bowel obstruction). Once this “ulcer rupture” has occurred, immediate surgery is necessary to prevent the affected person from dying. Appetite is generally undisturbed.
Intolerances or aversions to certain foods may be noted. Frequently this symptom is found with “acid looseners”, i.e. with foods that particularly stimulate gastric juice formation, i.e. also “make the water in the mouth flow together”, for example spicy fried food, meat broth, fat baked food, concentrated alcohol, sour wines, black coffee, hot spices.
Other signs of an ulcer
The facial expression is often suffering, with sunken cheeks and deep wrinkles extending from the nose to the corners of the mouth. If the patient vomits frequently, this may indicate obstruction of the gastric outlet as a result of acute ulcers or shrinking ulcer scars. However, vomiting may also occur as an ulcer symptom without obstruction to gastric emptying; the mechanism is unclear.
Weight loss is the result of vomiting, loss of appetite, or food restriction (to avoid food-dependent ulcer pain) in many ulcers. A healed duodenal ulcer may cause narrowing of the small bowel diameter due to scarred tissue, obstructing gastric emptying. This can lead to repeated vomiting.
