Duodenal ulcer hemorrhage with and without dyspepsia. To clarify the clinical significance of dyspepsia in patients with bleeding duodenal ulcer, we studied 298 patients prospectively. Ages of patients ranged from 16 to 81 yr (mean 45.9). There were 244 (82%) dyspeptic and 54 (18%) nondyspeptic patients. In the dyspeptic group, significantly more patients were taking nonsteroidal anti-inflammatory drugs. In the nondyspeptic group, there was a higher percentage of patients with duodenal bulb deformity (p less than 0.005), which deformity was related to previous peptic ulcer disease. The age, sex, past history of dyspepsia or bleeding, consumption of alcohol and cigarettes, and the hospital course of the two groups of patients did not differ significantly. Our results show that the clinical course of duodenal ulcer hemorrhage is not significantly different in patients with or without dyspepsia, and indicate that bleeding and dyspepsia probably are two independent presentations in the natural course of the disease. The significance of the correlation between dyspepsia and duodenal bulb deformity is discussed. 