Gastric<unk>  Duodenal<unk>  A2 stage, acute duodenal mucosal lesion(ADML) Signs and symptoms of a<unk><unk>  can include one or more of the following: *abdominal pain, classically epigastric, strongly correlated with mealtimes. In case of duodenal<unk> s, the pain appears about three hours after taking a meal and wakes the person from sleep; *bloating and abdominal fullness; *waterbrash (a rush of saliva after an episode of regurgitation to dilute the acid in esophagus, although this is more associated with gastroesophageal reflux disease); *nausea and copious vomiting; *loss of appetite and weight loss, in gastric<unk> ; *weight gain, in duodenal<unk> , as the pain is relieved by eating; *hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric<unk>  or from damage to the esophagus from severe/continuing vomiting. *melena (tarry, foul-smelling feces due to presence of oxidized iron from hemoglobin); *rarely, an<unk>  can lead to a gastric or duodenal perforation, which leads to acute peritonitis and extreme, stabbing pain, and requires immediate surgery. A history of heartburn or gastroesophageal reflux disease (GERD) and use of certain medications can raise the suspicion for<unk><unk> . Medicines associated with<unk><unk>  include NSAIDs (non-steroid anti-inflammatory drugs) that inhibit cyclooxygenase and most glucocorticoids (e.g., dexamethasone and prednisolone). In people over the age of 45 with more than two weeks of the above symptoms, the odds for<unk><unk> ation are high enough to warrant rapid investigation by esophagogastroduodenoscopy. The timing of symptoms in relation to the meal may differentiate between gastric and duodenal<unk> s. A gastric<unk>  would give epigastric pain during the meal, associated with nausea and vomiting, as gastric acid production is increased as food enters the stomach. Pain in duodenal<unk> s would be aggravated by hunger and relieved by a meal and is associated with night pain. Also, the symptoms of<unk><unk> s may vary with the location of the<unk>  and the person's age. Furthermore, typical<unk> s tend to heal and recur, and as a result the pain may occur for few days and weeks and then wane or disappear. Usually, children and the elderly do not develop any symptoms unless complications have arisen. A burning or gnawing feeling in the stomach area lasting between 30 minutes and 3 hours commonly accompanies<unk> s. This pain can be misinterpreted as hunger, indigestion, or heartburn. Pain is usually caused by the<unk> , but it may be aggravated by the stomach acid when it comes into contact with the<unk> ated area. The pain caused by<unk><unk> s can be felt anywhere from the navel up to the sternum, it may last from few minutes to several hours, and it may be worse when the stomach is empty. Also, sometimes the pain may flare at night, and it can commonly be temporarily relieved by eating foods that buffer stomach acid or by taking anti-acid medication. However,<unk>  symptoms may be different for every sufferer. Complications *Gastrointestinal bleeding is the most common complication. Sudden large bleeding can be life-threatening. It is associated with 5% to 10% death rate. *Perforation (a hole in the wall of the gastrointestinal tract) following a gastric<unk>  often leads to catastrophic consequences if left untreated. Erosion of the gastrointestinal wall by the<unk>  leads to spillage of the stomach or intestinal contents into the abdominal cavity, leading to an acute chemical peritonitis. The first sign is often sudden intense abdominal pain, as seen in Valentino's syndrome. Posterior gastric wall perforation may lead to bleeding due to the involvement of gastroduodenal artery that lies posterior to the first part of the duodenum. The death rate in this case is 20%. *Penetration is a form of perforation in which the hole leads to and the<unk>  continues into adjacent organs such as the liver and pancreas. *Gastric outlet obstruction (stenosis) is a narrowing of the pyloric canal by scarring and swelling of the gastric antrum and duodenum due to<unk><unk> s. The person often presents with severe vomiting. *Cancer is included in the differential diagnosis (elucidated by biopsy), Helicobacter pylori as the etiological factor making it 3 to 6 times more likely to develop stomach cancer from the<unk> . The risk for developing gastrointestinal cancer also appears to be slightly higher with gastric<unk> s
Peptic ulcer disease
Gallstone
Stress ulcer
Coronary artery disease
Acid peptic diseases
Stomach cancer
Gastric varices
Gastritis