Peptic Ulcers (cont.)
Peptic Ulcer Diagnosis
To confirm that a person has an ulcer, he or she will most likely undergo a diagnostic imaging test. The two most widely used tests are:
- Upper GI series (UGI): This is a type X-ray. The patient is given a chalky liquid to drink that increases the contrast on the
X-ray, making certain features easier to see. Because this liquid contains barium, this test is sometimes called a barium swallow.
- Endoscopy (EGD): An endoscope is a thin, flexible tube with a tiny camera on the end.
The patient is given a mild sedative,and then the tube is passed through the mouth into
the stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer.
Tiny samples of the tissue will be taken (biopsy), which are examined under a microscope.
If a diagnostic imaging test reveals an ulcer, the patient will most likely have a test to see if H pylori bacteria are present.
- It is important to be certain about this, because treatment of the H pylori is likely to heal the ulcer.
- Ulcers caused by H pylori are treated differently than ulcers caused by medications.
Three types of tests are available to detect H pylori.
- Blood tests: These tests detect the bacteria by measuring antibodies to the bacteria. Antibodies are proteins produced by the immune system to defend against an "invader" such as H pylori. The blood test is inexpensive and can be done in a medical office. The down side is that it can be positive in a person who had an ulcer before and was already treated for it.
- Breath test: This test detects H pylori by measuring carbon dioxide in the breath of a person who has drunk a special liquid. H pylori bacteria break down the liquid, increasing the amount of carbon in the blood. The body gets rid of this carbon by breathing it out as carbon dioxide. This test is more accurate than the blood test but is more difficult to carry out. It is often used after treatment to check whether H pylori bacteria have been eradicated.
- Tissue tests: These tests are used only if an endoscopic biopsy has been done, because a sample of tissue from the stomach is needed to detect the bacteria.
Michael W Stratemeier, MD
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