Clinical features in the diagnosis of peptic ulcer in Malawian adults

ABSTRACT

The predictive value of clinical features in the diagnosis of peptic ulcer diseases was studied in 104 Malawian adults (mean age 36 years) with epigastric pain who were consecutively investigated by fiber-optic endoscopy. In 40 patients with peptic ulcer and 64 with a normal investigation; clinical features with a positive predictive value greater than 50 percent included male subject; farming occupation; cigarette smoking; alcohol consumption; episodic pain; vomiting and hematemesis. The triad of smoking plus episodic pain plus nocturnal pain gave a predictive value of 90 percent. Attention in the history to these clinical features should allow a more accurate clinical diagnosis of peptic ulcer in patients presenting with epigastric pain