How Do You Check for an Ulcer?

Reviewed on 5/24/2022
A doctor performing an endoscopy in order to check for an ulcer
Tests used to diagnose a peptic ulcer (gastric or duodenal) include upper endoscopy, biopsy (often taken during the upper endoscopy), barium swallow, and H. pylori testing.

Ulcers are a type of sore in which open sores form in the upper part of the digestive tract that can cause stomach pain or upset and can lead to internal bleeding

There are two types of peptic ulcers

  • Gastric ulcers form on the lining of the stomach
  • Duodenal ulcers form on the lining of the upper part of the small intestine (the duodenum)

4 Main Tests for Ulcers

When you suspect you may have an ulcer after experiencing symptoms such as bloating, stomach pain, acid reflux, and more, you will need to see a doctor. A doctor can check for an ulcer by performing a physical examination, taking your patient history, and ordering tests used to diagnose an ulcer such as:

What Are Symptoms of an Ulcer?

An ulcer may not always cause symptoms (called “silent ulcers”). When symptoms of an ulcer occur, they may include: 

  • Stomach pain
  • Upper abdominal pain or discomfort (may feel like burning or hunger)
  • Feeling full quickly when eating
  • Feeling bloated after eating
  • Belching
  • Heartburn or acid reflux 
  • Nausea
  • Vomiting (blood in the vomit in severe cases)
  • Black or tar-like stools, which indicates the presence of blood in the stools 
  • Abdominal pain that comes on several hours after eating, frequently during the night (duodenal ulcer)

What Causes an Ulcer?

Peptic ulcers are caused by acid eroding the lining of the stomach or the lining of the upper part of the small intestine (the duodenum), which may occur when there is excess acid in the system or when the protective layer of mucus on the lining is broken down.

The two main causes of peptic ulcers are bacterial infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve).

  • Bacterial infection with Helicobacter pylori (H. pylori) that lives in the stomach 
    • H. pylori bacteria contributes to the formation of stomach ulcers because it can cause: 
      • Increased acid in the stomach and small intestine
      • Inflammation of the lining of the digestive tract
      • A breakdown of the protective mucus layer
  • NSAID use to relieve pain and reduce inflammation
    • The type of NSAID, the dose, and how long it’s used are factors in whether a peptic ulcer may form
    • NSAIDs can cause changes in the protective mucus layer of the digestive tract which may lead to ulcers 

Risk factors for developing peptic ulcers include:

  • Other family members having ulcers due to H. pylori 
  • Smoking
  • Genetics
  • Alcohol abuse (may interfere with ulcer healing)
  • Psychological factors (stress, anxiety, and depression) can contribute to the development of ulcers and can interfere with healing and increase the risk of recurrence. 

There is no good evidence that certain foods and beverages can cause or worsen ulcers.

What Is the Treatment for an Ulcer?

Peptic ulcers may heal on their own without treatment, but ulcers that have not been completely treated often recur. People with peptic ulcer disease will need treatment to relieve symptoms and prevent complications.

Most peptic ulcers can be treated with medications. The choice of medication depends on the cause of the ulcer. 

  • Medications to treat ulcers caused by H. pylori 
  • Medications to treat ulcers not due to H. pylori include:
    • Proton pump inhibitors
    • H2 receptor antagonists

Other treatments to help heal stomach ulcers include:

  • Stopping nonsteroidal anti-inflammatory drugs (NSAIDs) 
  • Not smoking
  • Limiting alcohol consumption
  • Taking antacids 
Reviewed on 5/24/2022
Image Source: iStock Images