Pulse, Blood Pressure, Facial Appearance and Personality of Patients with Duodenal Ulcer

Dr. Karunakar Samal

Dr. Karunakar Samal

Keywords: Chronic duodenal ulcer, peptic ulcer personality, ulcer type facies, relative bradycardia, low blood pressure

Abstract

Background: Ulcer pain or dyspeptic symptoms are the main presenting feature of peptic ulcer disease. Clinical sign is rare.
Aim: To study the behaviour of pulse and blood pressure, facial appearance and personality of patients in proved duodenal ulcerations. Upper G.I. endoscopy was performed in 50 patients with relative bradycardia, low blood pressure and ulcer facies to know the pathology.
Material and Methods: The study included 130 patients with chronic duodenal ulcer and 50 persons with relative bradycardia, low blood pressure and typical ulcer facies. The pulse and blood pressure were studied in 30 cases before and after 1 month of antiulcer therapy.
Results: In addition to ulcer pain and dyspeptic symptoms, reeling of head, burning head, sleep disturbances and musculoskeletal aches were observed in 86.2%, 46.2%, 61.5% and 69.2% patients respectively. Irritability, angry for minor things, apprehension and inactiveness were seen in 87.7%, 86.3%, 89.2% and 84.6% respectively. Mean pulse rate was 61.8 ± 6.3 (range 52-78), mean systolic blood pressure was 99.3 ± 8.6 (range 80-130) and mean diastolic blood pressure was 65.4 ± 10.6 (range 50-80). Sunken, cheeks and nasolabial fold changes were observed in 83.8% and 95.40% cases respectively. The pulse and blood pressure were significantly increased after 1 month antiulcer therapy. Chronic duodenal ulcer, antral gastritis, antral gastritis with GORD, pangastritis, biliary gastritis, gastric ulcer, gastric carcinoma, GORD were found out in 40%, 20%, 6%, 4%, 2%,6%, 4%, 8% respectively and with normal endoscopy in 10% of patients who had relative bradycardia, low blood pressure and ulcer facies.
Conclusions: Relative bradycardia, low blood pressure, ulcer facies along with the personality of patient may be helpful for diagnosing peptic ulcer disorders

References

1. Classen M, Dammann HG, Scheep W. The ulcer patient in General Practice. Hoechst Medication Up-date. Series Gastroenterology.1991; Hoechst AG.
2. Kurata JH, Nogawa AN. Meta-analysis of risk factors for peptic ulcer. Non-steroidal anti-inflammatory drugs, helicobacter pylori and smoking. J Clin Gastroenterol. 1997;24: 2-17.
3. Katoh K, Nomura M, Nakaya Y et al. Autonomic nervous activity before and after eradication of Helicobacter pylori in patients with chronic duodenal ulcer. Alment Pharmacol Ther. 2002; 16(2):180-186.
4. French D, Porter RW, Von Amerongen Fk, et al. Gastrointestinal haemorrhage and ulceration associated with intracranial lesions. Surgery. 1952;32:395-407.
5. Matsuo Y. Autonomic nerve and peptic ulcer. Medicina. 1993;30:1598-603.
6. Aoyama N, Kinoshita Y, Pajimoto S et al. Peptic ulcers after the Harshin- Awaji earthquakes : Increased incidence of bleeding gastric ulcers. Am J Gastroenterol. 1998;9:291-2.
7. Nomura M, Yukinaka M, Miyajima H et al. Is autonomic dysfunction a necessary condition for chronic peptic ulcer formation? Alment Pharmacol Ther. 2000:14 (Suppl. 1): 82-6.
8. Yukinaka M, Nomura M, Saijyo T, et al. Evaluation of autonomic nervous function in patients with essential hypertension complicated with peptic ulcer. J. Gastroenterol Hepatic. 2000;15:40-4.
9. Hilton D, Iman M, Burke Gl et al. Absence of abdominal pain in older persons with endoscopic ulcers : A prospective study. Am J. Gastroenterol. 2001; 96:380-4.