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Esophageal ulcer - Symptoms
Last reviewed: 04.07.2025
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Symptoms of esophageal ulcer include:
- Retrosternal pain is the most important symptom of an esophageal ulcer. As a rule, it occurs during meals. If the ulcer is located directly in the cardia or subcardia, the pain is felt high in the epigastrium or in the area of the xiphoid process.
- Dysphagia is a sensation of difficulty in the passage of food through the esophagus, caused by inflammatory edema of the mucous membrane of the esophagus and its dyskinesia. In some cases, dysphagia is caused by the development of ulcerative stenosis of the esophagus; in this case, regurgitation of esophageal contents is added.
- Heartburn - caused by gastroesophageal reflux, can be severe and forces patients to frequently take soda.
- Vomiting is a common symptom of esophageal ulcers and may be accompanied by blood in the vomit. Vomiting brings relief, reduces heartburn and pain.
- In severe clinical cases of esophageal ulcers, the patient experiences weight loss.
Complications of esophageal ulcer:
Esophageal stenosis - manifests itself as severe dysphagia, increased chest pain, and severe weight loss. X-ray examination of the esophagus reveals severe disruption of barium passage through the esophagus or even cessation of barium passage into the stomach. Suprastenotic expansion of the esophagus is also determined.
Esophageal perforation is a serious complication requiring emergency care. Most often, an esophageal ulcer perforates into the mediastinum. In this case, severe pain suddenly appears behind the breastbone, radiating to the back, sharply increasing when swallowing, as well as vomiting scarlet blood. There is severe shortness of breath, tachycardia, blood pressure quickly drops, and collapse develops. Subcutaneous emphysema is sometimes determined when palpating the chest.
Perforation of the esophageal ulcer into the left pleural cavity is possible. This is accompanied by a sharp increase in chest pain, dysphagia, shortness of breath, cyanosis, development of pneumothorax or exudative pleurisy. G. I. Lukomsky (1957) described perforation of the esophageal ulcer into the aorta. In this case, the patient quickly dies from severe hemorrhagic shock.
Acute bleeding - vomiting of scarlet blood suddenly appears, blood pressure drops rapidly, the patient breaks out in a cold sweat, tachycardia is observed. In case of massive bleeding, a fatal outcome is possible.
Chronic bleeding is manifested by a positive Gregersen reaction (determination of occult blood in the stool) and the development of iron deficiency anemia.