Doctors use simple tests and imaging to make an ulcer diagnosis.
People who experience a burning pain in the area between the navel and to the breastbone should consider having a doctor perform an ulcer diagnosis. This is especially true if other ulcer symptoms are present.
These symptoms include pain that last from a few minutes to several hours, an increase in the level of pain on an empty stomach, temporary relief from pain after eating foods that reduce the level of stomach acid, a decrease in the pain level after taking acid-reducing medication, or an increase in the level of pain at night.
Other symptoms, though less common, include vomiting blood, blood in the stool, unexplained weight loss, chest pain or nausea. If a doctor believes these symptoms warrant an ulcer diagnosis, then a variety of tests may be ordered, including an X-ray, an endoscopy, a blood test, a breath test or a stool test.
According to the Centers for Disease Control and Prevention, approximately 25 million Americans suffer from ulcers at some point in their lifetime. This leads to more than 1 million hospitalizations related to peptic ulcer disease. The most common method in ulcer diagnosis is an X-ray test. In an upper gastrointestinal (GI) series, a patient drinks a liquid with barium in it (called a barium swallow), which allows a doctor to see problems like ulcers during the X-ray.
If an upper GI series indicates the possibility of ulcers, then a doctor may order an endoscopy to confirm peptic ulcer disease. In an endoscopy, the doctor inserts a tube with a camera into the stomach via the esophagus. The camera allows the doctor to view the inside of the esophagus, the stomach and upper part of the small intestine, called the duodenum.
The doctor may also decide to do a biopsy, which involves taking a small sample of the infected area. Doctors may sedate patients before an endoscopy or biopsy.
In addition to X-rays and endoscopies, a doctor may order one of three simple tests to determine the presence of Helicobacter pylori (H. pylori), the bacteria that cause the majority of ulcers. The tests do not confirm the presence of ulcers as well as X-rays or endoscopy, which is why doctors refer to them as simple. These simple tests include tests of the blood, breath or stool.
In a blood test, a doctor takes a sample of blood and has it analyzed for the presence of H. pylori antibodies. According to the Mayo Clinic, H. pylori will infect 1 in 5 people under the age of 30 and half the people over the age of 60 who live in the United States.
Even though H. pylori bacteria infects a number of people, it does not always result in the formation of ulcers, so a blood test may not be conclusive in ulcer diagnosis. Another downfall of the blood test is the fact that the blood test cannot distinguish between current infections and previous infections. In some cases, people get positive result months after treating the infection.
Another simple test is the breath test. This test measures the amount of carbon dioxide in a person's breath before and after drinking a liquid that contains urea. If present, H. pylori bacteria breaks down the urea, which contains a radioactive carbon, within a 30-minute time period. The breath test is better than the blood test at identifying whether H. pylori still remains in the body. According to the National Institute of Diabetes and Digestive and Kidney Diseases, the breath test has an accuracy rate of 96 to 98 percent.
The final simple test is a stool test. In this test, a doctor collects a stool sample and has it analyzed for the presence of H. pylori. This test is similar to the breath test in identifying whether H. pylori bacteria are currently in the body. Doctors also use a stool test to monitor success in treating an ulcer.