Differentials
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MaagklachtenPublished by: NHGLast published: 2025Peptic ulcer disease (PUD)
SIGNS / SYMPTOMS
Clinical signs and symptoms may be similar.
INVESTIGATIONS
Peptic ulcer disease is strongly associated with Helicobacter pylori infection and nonsteroidal anti-inflammatory drug (NSAID) use.[4]
Stool heme test may be positive indicating occult gastrointestinal bleeding. Frank blood in the stool suggests brisk bleeding.
Endoscopy shows presence of peptic ulcer.
Gastroesophageal reflux disease (GERD)
SIGNS / SYMPTOMS
Clinical signs and symptoms may be similar.
GERD is characterized by specific esophageal and extra-esophageal symptoms.[50]
INVESTIGATIONS
H pylori urea breath test is negative.
Endoscopy and esophageal histology show esophageal involvement.
Nonulcer dyspepsia
SIGNS / SYMPTOMS
Clinical signs and symptoms may be similar to symptomatic gastritis and PUD.
Gastric lymphoma
SIGNS / SYMPTOMS
Clinical signs and symptoms may be similar.
INVESTIGATIONS
Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is strongly associated with H pylori infection.[4] Stool heme test may be positive indicating occult GI bleeding.
Endoscopy may show presence of ulcer or nonspecific mucosal abnormalities. Biopsies show histologically abnormal lymph follicle architecture with variable number of blast cells.
Molecular cytogenetics (e.g., reverse transcriptase polymerase chain reaction [PCR] or fluorescence in situ hybridization) may show characteristic t(11;18) translocation within lymphoid cells.
Gastric carcinoma
SIGNS / SYMPTOMS
Patient may have suspicious features (e.g., bleeding, anemia, early satiety, unexplained weight loss [>10% body weight], progressive dysphagia, odynophagia, or persistent vomiting).
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