Final answer:
Peptic ulcer disease usually presents with symptoms such as abdominal pain, nausea, bloating, and gas, but not typically with fever. Fever might be associated with complications from an ulcer but is not a direct symptom of the ulcer itself.
Step-by-step explanation:
The clinical presentation of peptic ulcer disease includes a range of symptoms but fever is not typically one of them. The symptoms of peptic ulcers include abdominal pain, which often occurs at night and might improve with eating, nausea and vomiting, bloating and gas, and less commonly, symptoms like belching, vomiting, weight loss, and poor appetite.
A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine (duodenum), which is most often caused by an infection with the bacterium Helicobacter pylori. While systemic symptoms such as fever could be associated with complications arising from a peptic ulcer, such as perforation or with concurrent infections, fever is not typically a direct presentation of a peptic ulcer itself, hence option 4, fever, is the correct answer to the question regarding which symptom does not typically present with peptic ulcers.