Gastroduodenitis represents the inflammation of the mucosa of the stomach and duodenum. Gastroduodenal ulcer is characterized by the appearance of an ulceration located on the stomach, the upper portion of the duodenum, the lower part of the esophagus, or the anastomotic loop of the stomach.
The gastroduodenal ulcer has a course characterized by alternating painful periods with periods of calm. Periods with painful manifestations are determined either by the appearance of the ulcer or by the recurrence of a chronic ulcer. The most constant symptom of gastroduodenal ulcer is pain, which has an epigastric localization, being intense, accompanied by a burning sensation and often radiates to the back.
The most valuable characteristic of the pain is its periodicity: the pains occur in periods of 1 - 3 weeks, separated by periods of calm, during which the patient does not complain of pain, even if they do not follow the dietary regimen. Most often, the painful periods occur during the autumn or spring (seasonal periodicity), but they can also occur in other seasons; as the disease becomes chronic, the painful periods become longer and more frequent. Another characteristic of the pain is that it has an hourly rhythm in relation to meal times. Sometimes, the pain occurs immediately after a meal (early pain), as in ulcers located juxtacardially or on the lesser curvature of the stomach; other times, it occurs 2 - 4 hours after a meal (late pain), as in the pyloroduodenal localization of the ulcer. Sometimes, the pains occur at night, around midnight or at 3-4 o'clock in the morning (in duodenal ulcers), in other cases of duodenal ulcer, the pain may be accompanied by a sensation of hunger (painful hunger).
In general, the pain from gastroduodenal ulcer is relieved by food intake or sodium bicarbonate (or other alkaline substances). As the ulcer becomes chronic and lesions of perigastritis or periduodenitis appear, the pain becomes almost constant, with the periodicity and hourly rhythm tending to be less pronounced. The retrosternal burning sensation (heartburn) is a common sign, which sometimes replaces the pain and has a rhythmic and periodic character. Additionally, acidic eructations, sour or bitter taste in the mouth may occur.
Vomiting, when it occurs, is usually postprandial, early or late, depending on the gastric or duodenal localization of the ulcer, being determined by heavier meals, deviations from the diet, consumption of alcoholic beverages. Vomiting contains food, is abundant, and has an acidic odor; sometimes, the patient vomits no more pure gastric juice. A characteristic of vomiting is that it alleviates the pain, often even making it disappear, which is why some patients induce vomiting themselves.
Appetite is normal or increased. If the patient loses weight during painful periods and it is said that they don't eat, this does not happen due to loss of appetite, but out of fear of eating to avoid pain.
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