The first symptom of a perforated peptic ulcer is usually sudden, severe, sharp pain in the abdomen.

It is characteristically made worse by any movement, and greatly intensifies with coughing or sneezing.

[citation needed] Causes include alcohol, smoking, consuming highly acidic foods and beverages (such as coffee), and nonsteroidal anti-inflammatory drugs (NSAIDs).

This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer.

[5] Perforated peptic ulcer is a serious condition with an overall reported mortality of 5%–25%, rising to as high as 50% with age.