The most relevant clinical presentations of
duodenal ulcer disease are
pain and acute
bleeding. The purpose of this study was to investigate the relevance of
dyspepsia in patients with
bleeding duodenal ulcer, and to compare the clinical and epidemiological characteristics of
bleeding patients with and without
dyspepsia. A total of 82 patients with isolated
duodenal ulcer and
bleeding were included in this study. There were 48 (58.5%) dyspeptic and 34 (41.5%) nondyspeptic patients. The patients with and without
dyspepsia were almost identical with regard to their age (52.9 +/- 11.9 vs 53.4+/- 10.2 years, p > 0.05). In the dyspeptic group, significantly more patients had
duodenitis and a deformed bulb (chi 2 = 4.05, p < 0.05 and chi 2 = 3.99, p < 0.05, respectively). Patients with
bleeding duodenal ulcers and
dyspepsia were more likely to have taken non-steroidal anti-inflammatory drugs (45.8 vs 8.8%; chi 2 = 11.18, p < 0.001), whereas significantly more patients in the nondyspeptic group have taken
histamine H2 antagonists (85.3 vs 8.3%; chi 2 = 45.87, p < 0.01). No significant difference was found between the dyspeptic and nondyspeptic groups with regard to the previous diagnosis of
peptic ulcer bleeding, the presence of environmental stress,
gastritis, and alcohol or tobacco consumption. Furthermore, there was no significant difference in regard to the rebleeding, the need for urgent operation or
hospital stay. The results of this study support the evidence that in patients with
bleeding duodenal ulcers the dyspeptic symptoms were more often associated with objective signs of duodenal pathology, and the use of non-steroidal anti-inflammatory drugs and maintenance treatment with
histamine H2 antagonists was associated with silent
duodenal ulcer bleeding.