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How is peptic ulcer diagnosed?

The diagnosis can only be confirmed or excluded by a gastroscopy. A gastroscopy (or upper GI endoscopy) involves the visualisation of the lining of your gullet (oesophagus), stomach and duodenum with a small fibre-optic camera that can be

swallowed.

The gastroscopy is more helpful in diagnosis if it is performed before you take any acid-reducing medication. An endoscope is a thin, flexible tube with a tiny camera on the end. You are given a mild sedative, then the tube is passed through your mouth into your stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer. He or she will usually take tiny samples of the tissue (biopsy), which are examined under a microscope.

An X-ray examination (involving a Barium meal) can also be used, but it is not quite as reliable or helpful a diagnostic tool as a gastroscopy. It does not offer any opportunity to take tissue samples (biopsies) for microscopic diagnosis of tissue abnormalities and infection.

If a diagnostic imaging test reveals an ulcer, the patient will probably have a test to see if H pylori bacteria are present.

Blood test checks for the presence of H. pylori antibodies. A disadvantage of this test is that it sometimes can't differentiate between past exposure and current infection. After H. pylori bacteria have been eradicated, you may still have a positive result for many months.

Breath test uses a radioactive carbon atom to detect H. pylori. First, you blow into a small plastic bag, which is then sealed. Then, you drink a small glass of clear, tasteless liquid. The liquid contains radioactive carbon as part of a substance (urea) that will be broken down by H. pylori. Thirty minutes later, you blow into a second bag, which also is sealed. If you're infected with H. pylori, your second breath sample will contain the radioactive carbon in the form of carbon dioxide. It takes about a day to get the test results.

Stool antigen test checks for H. pylori in stool samples. It's useful in helping to diagnose H. pylori infection. It may also be useful in monitoring the success of treatment.

More information on peptic ulcer

What is a peptic ulcer? - Peptic ulcer is a non-malignant ulcer of the stomach (called gastric ulcer) or duodenum. A peptic ulcer of the stomach is called a gastric ulcer.
What causes peptic ulcer? - The major cause peptic ulcer of is chronic inflammation due to Helicobacter pylori. Another major cause is the use of NSAIDs.
What are symptoms of peptic ulcer? - Symptoms of a peptic ulcer can be abdominal pain, hematemesis (vomiting blood), melena (tarry feces due to oxidised iron from hemoglobin), weight loss.
How is peptic ulcer diagnosed? - The diagnosis of peptic ulcer can only be confirmed or excluded by a gastroscopy. Blood test checks for the presence of H. pylori antibodies.
What are the complications of peptic ulcers? - Gastrointestinal bleeding is a serious complication of peptic ulcer. Another serious ulcer complication is perforation.
What treatments are available for peptic ulcers? - Choice of treatment for peptic ulcers depends on whether the ulcer is caused by infection with H pylori.
What medications cure peptic ulcers? - Several combinations of antibiotics kill H. pylori. Antacids relieve symptoms of ulcers by neutralizing stomach acid. 
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