Diagnosis of Peptic Ulcers (Stomach Ulcers)

How do doctors diagnose a peptic ulcer?

Your doctor will use information from your medical history, a physical exam, and tests to diagnose an ulcer and its cause. The presence of an ulcer can only be determined by looking directly at the stomach with endoscopy or an X-ray test.

Medical history

To help diagnose a peptic ulcer, your doctor will ask you questions about your medical history, your symptoms, and the medicines you take.

Be sure to mention medicines that you take without a prescription, especially nonsteroidal anti-inflammatory drugs (NSAIDs), such as

Doctor talking to a patient.

Physical Exam

A physical exam may help a doctor diagnose a peptic ulcer. During a physical exam, a doctor most often

  • checks for bloating in your abdomen
  • listens to sounds within your abdomen using a stethoscope
  • taps on your abdomen checking for tenderness or pain

Lab tests

To see if you have a Helicobacter pylori (H. pylori) infection, your doctor will order these tests:

Blood test. A blood test involves drawing a sample of your blood at your doctor’s office or a commercial facility. A health care professional tests the blood sample to see if the results fall within the normal range for different disorders or infections.

Urea breath test. For a urea breath test, you will drink a special liquid that contains urea, a waste product that your body makes as it breaks down protein. If H. pylori are present, the bacteria will change this waste product into carbon dioxide—a harmless gas. Carbon dioxide normally appears in your breath when you exhale.

A health care professional will take a sample of your breath by having you breathe into a bag at your doctor’s office or at a lab. He or she then sends your breath sample to a lab for testing. If your breath sample has higher levels of carbon dioxide than normal, you have H. pylori in your stomach or small intestine.

Stool test. Doctors use a stool test to study a sample of your stool. A doctor will give you a container for catching and storing your stool at home. You return the sample to the doctor or a commercial facility, who then sends it to a lab for analysis. Stool tests can show the presence of H. pylori.

Upper gastrointestinal (GI) endoscopy and biopsy

In an upper GI endoscopy, a gastroenterologist, surgeon, or other trained health care professional uses an endoscope to see inside your upper GI tract. This procedure takes place at a hospital or an outpatient center.

An intravenous (IV) needle will be placed in your arm to provide a sedative. Sedatives help you stay relaxed and comfortable during the procedure. In some cases, the procedure can be performed without sedation. You will be given a liquid anesthetic to gargle or spray anesthetic on the back of your throat. The doctor will carefully feed the endoscope down your esophagus and into your stomach and duodenum. A small camera mounted on the endoscope sends a video image to a monitor, allowing close examination of the lining of your upper GI tract. The endoscope pumps air into your stomach and duodenum, making them easier to see.

The doctor may perform a biopsy with the endoscope by taking a small piece of tissue from the lining of your esophagus. You won’t feel the biopsy. A pathologist examines the tissue in a lab.

Read more about Upper GI Endoscopy.

Upper GI series

An upper GI series looks at the shape of your upper GI tract. An x-ray technician performs this test at a hospital or an outpatient center. A radiologist reads and reports on the x-ray images. You don’t need anesthesia. A health care professional will tell you how to prepare for the procedure, including when to stop eating and drinking.

During the procedure, you’ll stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats your esophagus, stomach, and small intestine so your doctor can see the shapes of these organs more clearly on x-rays.

You may have bloating and nausea for a short time after the test. For several days afterward, you may have white or light-colored stools from the barium. A health care professional will give you instructions about eating and drinking after the test.

Computerized tomography (CT) scan

A CT scan uses a combination of x-rays and computer technology to create images. For a CT scan, a health care professional may give you a solution to drink and an injection of a special dye, which doctors call contrast medium. You’ll lie on a table that slides into a tunnel-shaped device that takes the x-rays. An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. You don’t need anesthesia.

CT scans can help diagnose a peptic ulcer that has created a hole in the wall of your stomach or small intestine.

November 2014
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.