How is peptic ulcer diagnosed?

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.

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