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Tests and diagnosis
By Mayo Clinic staffIn order to detect an ulcer, you may have to undergo diagnostic tests, such as:
- Blood test. This 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. Additionally, a false-negative is possible if you've recently been taking certain drugs, such as antibiotics or proton pump inhibitors.
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Breath test. This procedure uses a radioactive carbon atom to detect H. pylori. For the test, 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. Less than an hour later, you blow into a bag, which is then sealed. If you're infected with H. pylori, your breath sample will contain the radioactive carbon in the form of carbon dioxide.
The advantage of the breath test is that it can monitor the effectiveness of treatment used to eradicate H. pylori, detecting whether the bacteria have been killed or eradicated.
- Stool antigen test. This test checks for H. pylori in stool samples. It's useful both in helping to diagnose H. pylori infection and in monitoring the success of treatment.
- Upper gastrointestinal (upper GI) X-ray. This test outlines your esophagus, stomach and duodenum. During the X-ray, you swallow a white, metallic liquid (containing barium) that coats your digestive tract and makes an ulcer more visible. An upper GI X-ray can detect some ulcers, but not all.
- Endoscopy. This procedure may follow an upper GI X-ray if the X-ray suggests a possible ulcer, or your doctor may perform endoscopy first. In this more sensitive procedure, a long, narrow tube with an attached camera is threaded down your throat and esophagus into your stomach and duodenum. With this instrument, your doctor can view your upper digestive tract and identify an ulcer. Your doctor will perform this test if you have other signs or symptoms, such as difficulty swallowing, weight loss, vomiting (particularly vomiting red or black material that looks like coffee grounds), black stools or anemia.
If your doctor detects an ulcer, he or she may remove small tissue samples (biopsy) near the ulcer. These samples are examined under a microscope to rule out cancer. A biopsy can also identify the presence of H. pylori in your stomach lining. Depending on where the ulcer is found, your doctor may recommend a repeat endoscopy after two to three months to confirm that the ulcer is healing.
- H. pylori and peptic ulcer. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/. Accessed Oct. 16, 2008.
- What I need to know about peptic ulcers. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/pepticulcers_ez/. Accessed Oct. 16, 2008.
- Peptic ulcer disease. American Gastroenterological Association. http://www.gastro.org/frame-templates/print_template.cfm. Accessed Oct. 16, 2008.
- Soll AH. Peptic ulcer disease: Genetic, environmental, and psychological risk factors and pathogenesis. http://www.uptodate.com/home/index.html. Accessed Oct. 16, 2008.
- Soll AH. Overview of peptic ulcer: Epidemiology and major causes. http://www.uptodate.com/home/index.html. Accessed Oct. 16, 2008.
- Lau JY. Omeprazole before endoscopy in patients with gastrointestinal bleeding. New England Journal of Medicine. 2007;356(16):1631-1640.
- Yang YX. Long-term proton pump inhibitor therapy and risk of hip fracture. Journal of the American Medical Association. 2007;296(24):2947-2953.
- Soll AH. Overview of the natural history and treatment of peptic ulcer disease. http://www.uptodate.com/home/index.html. Accessed Oct. 16, 2008.
- Soll AH. Treatment of refractory or recurrent peptic ulcer disease. http://www.uptodate.com/home/index.html. Accessed Oct. 16, 2008.
- Soll AH. Unusual causes of and diseases associated with peptic ulcer disease. http://www.uptodate.com/home/index.html. Accessed Oct. 16, 2008.
- Cryer B, et al. Peptic ulcer disease. In: Feldman M, et al. Sleisenger & Fortran's Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa. Saunders Elsevier. http://www.mdconsult.com/das/book/body/113080343-3/781010342/1389/364.html#4-u1.0-B1-4160-0245-6..50055-X--cesec29_2206. Accessed Nov. 3, 2008.
