Complications of untreated peptic ulcer disease
The most common complication of PUD is gastrointestinal blood loss. Occasionally, asymptomatic patients are found to be anemic on routine blood work. Other times, patients may present to the emergency room with significant GI tract bleeding. GI bleeding from PUD is treated with PPI therapy and removal of the underlying cause, such as Hp or NSAIDs. Endoscopic intervention may also be required.
A rare but serious complication of PUD is perforation. Patients with a perforation present with acute abdominal pain, guarding, and rebound tenderness. Emergency surgery may be required to close the defect in the intestinal wall. Occasionally, this is the initial manifestation of PUD.
Infrequently, patients with PUD may present with symptoms of gastric outlet obstruction. This is an increasingly rare complication of PUD given the widespread use of PPI therapy. Symptoms of gastric outlet obstruction include pain, nausea, vomiting, abdominal fullness, and early satiety. Patients may also note gastric distension and bloating.