Clinical evaluation

A. Symptoms of PUD include recurrent upper abdominal pain and discomfort. The pain of duodenal ulceration is often relieved by food and antacids and worsened when the stomach is empty (eg, at nighttime). In gastric ulceration, the pain may be exacerbated by eating.

B. Nausea aud vomiting are common in PUD. Hematemesis ("coffee ground" emesis) or melena (black tarry stools) are indicative of bleeding.

C. Physical examination. Tenderness to deep palpation is often present in the epigastrium, and the stool is often guaiac-positive.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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