IT IS A widely accepted idea that patients with peptic ulcer are most likely to develop symptoms in the spring and fall seasons.1-3 The complications of peptic ulcer, such as perforation, hemorrhage, or obstruction are dramatic events which clearly date the exacerbation of the disease.
Pain is the outstanding symptom of ulcer, but others are more insidious and, therefore, more difficult to place accurately in the chronology of the illness. The description of pain in peptic ulcer disease is generally characterized in terms of chronicity, the distinctive quality of ulcer distress, the rhythmic relationship to food intake, and finally, in terms of its periodicity.
There is little doubt that symptoms due to peptic ulcer are periodic. Exacerbations may occur at various periods followed by similar periods of remission. In fact, the unremitting persistence of ulcer symptoms should cause concern that a complication of ulcer is present or that the