Diagnosis and tests for peptic ulcer

Doctors diagnose a peptic ulcer by checking symptoms, testing for the cause and, when needed, looking inside the stomach.

Clinical review

The doctor asks about pain pattern, pain-tablet use, smoking, alcohol, family history, black stools and weight loss.

Tests for H. pylori

• Urea breath test: you drink a special liquid and breathe into a bag. It is accurate and non-invasive.
• Stool antigen test: detects the bacterium in a stool sample.
• Blood antibody test: shows past exposure but cannot confirm active infection, so it is used less often.
• Biopsy during endoscopy: a small tissue sample is tested.

Medicines such as acid reducers (PPIs) and antibiotics can affect breath and stool tests, so ask your doctor when to stop them before testing.

Upper GI endoscopy

A thin camera passes through the mouth to look at the food pipe, stomach and duodenum. It confirms the ulcer, allows biopsy and can treat bleeding. It is advised for people over about 45 to 50, with alarm signs, or if treatment fails.

Other tests

• Blood count and iron tests: to check for anaemia from slow bleeding
• Barium swallow X-ray: used less often now
• in rare cases to look for acid-excess conditions