Evidence Checklist: Peptic Ulcer Disease

Upper endoscopy (EGD) confirming ulcer location and sizeCritical

Esophagogastroduodenoscopy report documenting peptic ulcer location (gastric vs. duodenal), size, depth (superficial vs. penetrating), and presence of complications (bleeding, perforation).

Nexus opinion linking PUD to service ("at least as likely as not")Critical

A medical opinion connecting peptic ulcer disease to service-related NSAID use for service-connected pain, combat stress, H. pylori acquired during deployment, or other service-related factors.

H. pylori testing results (urea breath test, stool antigen, or biopsy CLO test)Critical

Test results confirming or ruling out H. pylori infection — the primary causative agent for duodenal ulcers. Positive results support an infectious etiology and treatment course.

Treatment records (PPIs, H. pylori eradication, surgery)

Records documenting PPI therapy, H. pylori eradication triple/quadruple therapy, and any surgical procedures (vagotomy, pyloroplasty, partial gastrectomy) for refractory disease.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Stomach and Duodenal ConditionsCritical

Standardized form capturing endoscopy findings, H. pylori status, complication history, weight impact, and treatment requirements.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.