Final answer:
(c) Perforation is a serious potential complication of peptic ulcer disease, which can create a hole in the stomach wall leading to peritonitis and requires surgical repair.
Step-by-step explanation:
One of the potential complications of peptic ulcer disease that Mr. Lewin could experience, despite treatment and attention to his diet, is perforation. Perforated ulcers can create a hole in the stomach wall, which could lead to peritonitis, an inflammation of the peritoneum. This is a very serious condition that requires surgical repair.
Other symptoms related to peptic ulcers can include nausea, a lack of appetite, bloating, burping, and weight loss. In addition, bleeding ulcers may produce dark-colored stools. If untreated, ulcers can worsen, involving more tissue and potentially leading to perforation, which would allow digestive enzymes and acid to leak into the body.