Peptic ulcer - Diagnosing a stomach ulcer

Your GP may suspect you have an ulcer based on your symptoms. In most cases they will treat you with an acid-suppressing medication and/or test and treat you for an H. pylori infection.

You may be referred for an endoscopy to look inside your stomach directly to see whether you have a stomach ulcer.

The procedure (called a diagnostic gastroscopy) is carried out in hospital and involves passing a thin, flexible tube (an endoscope) with a camera at one end into your mouth, through your gullet and into your stomach and duodenum.

The images taken by the camera will usually confirm or rule out an ulcer without the need for further tests.

During the procedure the specialist may also take a tissue sample from your stomach or duodenum. The sample can then be tested for the H. pylori bacteria.

A diagnostic gastroscopy isn't painful but some people find the experience uncomfortable. You can have your throat numbed with a local anaesthetic spray or you can be sedated.

Sedation makes you drowsy so you have little or no awareness of the gastroscopy being carried out. However, even with sedation, some people may still gag or find the procedure uncomfortable.

If you choose to have sedation, you will need someone to give you a lift home after the procedure and to stay with you for at least 24 hours.

If you have a local anaesthetic, you can leave hospital as soon as the procedure has been completed. You can resume normal activities within one-to-two hours.

Read more about diagnostic gastroscopy.

Diagnosing H. pylori infection

If your GP thinks your symptoms may be due to an H. pylori infection (which would usually be the case if you don't have a recent history of taking non-steroidal anti-inflammatory drugs), you may need one of several further tests. These are described below.

• A urea breath test – you will be given a special drink containing a chemical that is digested by H. pylori. Your breath is then analysed to see whether or not you have an H. pylori infection.
• A stool antigen test – a pea-sized stool sample is tested.
• A blood test – a sample of your blood is tested for antibodies to the H. pylori bacteria. Antibodies are proteins produced naturally in your blood and help fight infection.

If you test positive for H. pylori, you will need treatment to clear the infection. This can heal the ulcer and prevent it from coming back.

Read more about treating stomach ulcers.