Common complications are hemorrhage, perforation, obstruction, and cancer.
Peptic ulcer is a pathological condition in which the mucosa is digested by gastric acid, resulting in ulcer formation. There are four most common complications of peptic ulcers overall: bleeding, perforation, obstruction, and cancer.
Bleeding from peptic ulcers is the most common cause of upper gastrointestinal bleeding, which can be life-threatening if the ulcer is deep and involves large blood vessels, especially arteries.
Patients with peptic ulcers tend to have regular epigastric pain that is associated with eating, with patients with duodenal ulcers presenting with fasting pain that is relieved with meals. The opposite is true for patients with gastric ulcers, if there is a sudden knife-like pain that rapidly spreads throughout the abdomen, abdominal muscles are tense, and the typical patient has a hard abdomen like a plank, which may be accompanied by shock manifestations such as rapid heart rate, blood drop, and clammy skin, and subdiaphragmatic free gas is visible on standing abdominal plain film.
In patients with duodenal bulb and pyloric canal ulcers, the scarring formed during ulcer healing may lead to deformation of the duodenal bulb or pylorus, which may cause varying degrees of stenosis at the pyloric opening, and patients tend to have obstructive symptoms such as abdominal distention, abdominal pain, and vomiting after eating.
Cancer is one of the most serious complications of peptic ulcers, and it is thought that only gastric ulcers can become cancerous, while duodenal ulcers do not become malignant. The risk of developing gastric cancer is much higher in patients with gastric ulcers than in the general population, and the rate of malignancy is generally no more than 5% according to current research, with irregular abdominal pain that is not related to eating and may be accompanied by wasting, weakness, and other signs of general exertion.