Materiały źródłowe

• #1 Stomach Ulcer: Signs, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22314-stomach-ulcer

  A stomach ulcer occurs when stomach acid eats through your protective stomach lining, producing an open sore. […] A healthcare provider must identify the cause of your ulcer to recommend the right treatment. […] Your healthcare provider will begin by asking you about your symptoms and medical history. […] If signs point to an ulcer, theyll take a look inside your stomach to find it. […] Your healthcare provider will want to check for H. pylori infection, then look for the ulcer itself inside your stomach. […] One common method is an upper endoscopy exam, which can accomplish both at once. […] An upper endoscopy (EGD test) goes inside your stomach with a tiny camera on a long, thin tube (endoscope). […] Your provider can use these tools to take a tissue sample (biopsy) and test it for H. pylori.

• #1 Peptic ulcer disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/80?locale=en_GB

  Peptic ulcers usually present as chronic, upper abdominal pain related to eating a meal (dyspepsia). […] Endoscopy is diagnostic and may show an ulcer in the stomach or proximal duodenum. […] In the absence of „alarm” (red flag) symptoms or signs, testing for and treating H pylori and/or empiric acid inhibition therapy is appropriate. […] Key diagnostic factors include abdominal pain and „pointing sign”. […] Other diagnostic factors include epigastric tenderness, nausea or vomiting, early satiety, weight loss or anorexia, diarrhea, symptoms of anemia, gastrointestinal (GI) bleeding, hypotensive or septic shock, and succussion splash. […] 1st tests to order include Helicobacter pylori urea breath test or stool antigen test, upper gastrointestinal endoscopy, and CBC. […] Investigations to avoid include serology. […] Tests to consider include fasting serum gastrin level, CTA abdomen and pelvis without and with contrast, and arteriography visceral.

• #1 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Testing for H pylori infection is essential in all patients with peptic ulcers. Documentation of peptic ulcer disease depends on radiographic and endoscopic confirmation. […] If the diagnosis of peptic ulcer disease is suspected, obtaining a complete blood cell (CBC) count, liver function tests (LFTs), and levels of amylase and lipase may be useful. […] The 2017 American College of Gastroenterology (ACG) guidelines for the treatment of H pylori infection (HPI) include recommendations for testing for H pylori. […] The 2017 ACG guidelines also recommend posttreatment testing to prove eradication of HPI with the use of a urea breath test, fecal antigen test, or biopsy-based testing at least 4 weeks following the completion of antimicrobial therapy and after proton pump inhibitors have been withheld for 1-2 weeks.

• #1 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Upper gastrointestinal (GI) endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease. It is highly sensitive for the diagnosis of gastric and duodenal ulcers, allows for biopsies and cytologic brushings in the setting of a gastric ulcer to differentiate a benign ulcer from a malignant lesion, and allows for the detection of H pylori infection with antral biopsies for a rapid urease test and/or histopathology in patients with peptic ulcer disease. […] A fasting serum gastrin level should be obtained in certain cases to screen for Zollinger-Ellison syndrome. […] A secretin stimulation test may be required if the diagnosis of Zollinger-Ellison syndrome cannot be made on the basis of the serum gastrin level alone. […] A single biopsy offers 70% accuracy in diagnosing gastric cancer, but 7 biopsy samples obtained from the base and ulcer margins increase the sensitivity to 99%. […] The emergency department (ED) workup will vary depending on presentation and includes the following: Complete blood cell (CBC) count is used to evaluate acute or chronic blood loss.

• #1

  https://www.nhs.uk/conditions/stomach-ulcer/diagnosis/

  If a GP thinks you have a stomach ulcer, you may be tested for an Helicobacter pylori (H. pylori) infection. […] You may be referred to hospital for a procedure to look inside your stomach called a gastroscopy. […] If your GP thinks your symptoms are caused by an H. pylori infection, they may recommend one of the following tests: a urea breath test you’ll be given a drink containing urea (a chemical that’s broken down by H. pylori) and your breath is then checked after, a stool antigen test a small stool sample is tested for the bacteria, 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 to fight infection); this has now largely been replaced by the stool antigen test. […] If you test positive for H. pylori, you’ll need treatment to clear it, which can heal the ulcer and prevent it returning. […] This is a test to look inside your stomach directly and see whether you have a stomach ulcer. […] The images taken by the camera will usually confirm or rule out an ulcer. A small tissue sample may also be taken from your stomach or duodenum so it can be tested for the H. pylori bacteria.

• #1 Stomach ulcer | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/stomach-ulcer

  Diagnosing a stomach ulcer is done using a range of methods, including: […] Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a video capture device and highly detailed images of the stomach lining can be obtained. If a gastric ulcer has been found, the endoscopy must be repeated after treatment to ensure healing and exclude the possibility of cancer. […] Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found. […] C14 breath test checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon (C14) and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.

• #1 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  Endoscopy is recommended for patients who are 55 years or older, or who have alarm symptoms. […] The accuracy of diagnostic tests for H. pylori infection is summarized in Table 2. […] Urea breath tests require the ingestion of urea labeled with the nonradioactive isotope carbon 13 or carbon 14. […] Urea breath testing is one option for test of cure and should be performed four to six weeks after completion of eradication therapy. […] Stool antigen tests using monoclonal antibodies are as accurate as urea breath tests if a validated laboratory-based monoclonal test is used. […] Serologic antibody testing detects immunoglobulin G specific to H. pylori in serum and cannot distinguish between an active infection and a past infection. […] Endoscopy with biopsy is recommended to rule out cancer and other serious causes in patients 55 years or older, or with one or more alarm symptoms.

• #1 Peptic ulcer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/diagnosis-treatment/drc-20354229

  During an upper endoscopy, a healthcare professional inserts a thin, flexible tube equipped with a light and camera down the throat and into the esophagus. The tiny camera provides a view of the esophagus, stomach and the beginning of the small intestine, called the duodenum. […] To detect an ulcer, your healthcare professional may first take a medical history and do a physical exam. You also may need tests, such as: […] Laboratory tests for H. pylori. A blood, stool or breath test can show whether H. pylori is in your body. […] Endoscopy. During this procedure, your healthcare professional uses a long, flexible tube with a tiny camera, called an endoscope, to look at the upper part of your digestive system. Endoscopy involves passing the endoscope, down your throat and into your esophagus, stomach and small intestine to look for ulcers.

• #1 Peptic Ulcer Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534792/

  Peptic ulcer disease (PUD) is characterized by discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in the stomach and proximal duodenum. […] Today, testing for Helicobacter pylori is recommended in all patients with peptic ulcer disease. Endoscopy may be required in some patients to confirm the diagnosis, especially in those patients with sinister symptoms. […] Diagnosis of PUD requires history taking, physical examination, and invasive/non-invasive medical tests. A careful history should be obtained and noted for the presence of any complications. Patient reporting of epigastric abdominal pain, early satiety, and fullness following a meal raise suspicion of PUD. […] Investigations: Esophagogastroduodenoscopy (EGD): Gold standard and most accurate diagnostic test with sensitivity and specificity up to 90% in diagnosing gastric and duodenal ulcers. […] Anyone with the presence of alarm symptoms should undergo EGD, irrespective of age.

• #1 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). […] The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger than 55 years and the absence of alarm symptoms. Most other patients should undergo upper endoscopy to rule out malignancy and other serious causes of dyspepsia. […] The American College of Gastroenterology (ACG) recommends testing for H. pylori infection in patients with active PUD or history of PUD, dyspepsia symptoms, or gastric MALT lymphoma. […] The test-and-treat strategy for detecting H. pylori is appropriate in patients with dyspepsia and low risk of gastric cancer (age younger than 55 years and no alarm symptoms such as unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of gastrointestinal cancer, overt gastrointestinal bleeding, abdominal mass, iron deficiency anemia, or jaundice).

• #1 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Peptic ulcers are mucosal breaks of 3 mm or greater and are common, occurring in about 10% of adults in Western countries. Gastric ulcers account for about one third of peptic ulcers, and duodenal ulcers account for the remainder. Because a small percentage (5%) of gastric ulcers are caused by ulcerated gastric carcinomas, all gastric ulcers must be carefully assessed to differentiate benign lesions from malignant lesions. […] Fiberoptic endoscopy of the upper GI tract has become the diagnostic procedure of choice for patients with suspected duodenal ulcer. However, endoscopic examinations are more invasive and costly than double-contrast barium studies. Endoscopy with biopsy has a sensitivity of 95%, but multiple biopsy samples are needed to avoid sampling errors. […] The American Society of Gastrointestinal Endoscopy (ASGE) has published guidelines regarding endoscopy in patients with upper abdominal pain or dyspeptic symptoms that suggest peptic ulcer disease. The ASGE suggests that the decision to perform surveillance endoscopy in patients with a gastric ulcer be individualized. Surveillance endoscopy is suggested for patients with gastric ulcer who remain symptomatic despite an appropriate course of medical therapy.

• #1

  https://link.springer.com/article/10.1007/BF01309382

  The introduction of fiberoptic endoscopy has altered the relative importance of ulcer symptoms in the diagnosis of peptic ulcer disease. […] Modern forward-viewing endoscopes of small diameter enable precise diagnosis with little discomfort in 95% of all duodenal ulcer patients. A biopsy is only recommended in rare cases (giant ulcers) because the malignancy rate is only 0.024% in duodenal ulcers. The diagnostic accuracy of endoscopy in detecting gastric ulcer is as high as that for duodenal ulcer, but for this ulcer type it is absolutely necessary to exclude malignancy by obtaining a minimum of six biopsies (four from the ulcer margin and two from the ulcer base), since approximately 10% of all gastric ulcers are actually carcinomas. […] In experienced hands endoscopy is superior to radiography in duodenal and in gastric ulcer, although there is still a place for radiography as a supplementary investigation or if the patient rejects endoscopy. […] When selecting patients for treatment of peptic ulcer the following aspects must be considered: natural history of the disease, effectiveness of treatment, and risks and costs of treatment.

• #1 Peptic ulcer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/diagnosis-treatment/drc-20354229

  If the endoscopy shows an ulcer in your stomach, you’re likely to have a follow-up endoscopy after treatment. This can show if the ulcer has healed. […] Upper gastrointestinal series. Sometimes called a barium swallow, this series of X-rays of the upper digestive system makes pictures of your esophagus, stomach and small intestine. During the series of X-rays, you swallow a white liquid that has barium. The liquid coats your digestive tract and makes an ulcer easier to see. […] Treatment for peptic ulcers often leads to ulcer healing. But if your symptoms are severe or if you have them even with treatment, your healthcare professional may suggest endoscopy. This procedure can rule out other possible causes for your symptoms. […] If your healthcare professional finds an ulcer during endoscopy, you may need another endoscopy after your treatment to make sure your ulcer has healed. […] Peptic ulcers that don’t heal with treatment are called refractory ulcers. Reasons for an ulcer not healing include: Not taking medicines as prescribed. […] Treatment for refractory ulcers most often involves getting rid of factors that keep the ulcer from healing and trying other antibiotics.

• #1 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Single-contrast barium studies have an overall sensitivity of 75%, but double-contrast barium examinations have a sensitivity as high as 95% in the detection of gastric cancer. These results are comparable to those of endoscopy, and double-contrast barium examination remains a useful alternative to endoscopy. […] Although endoscopy remains the standard of care, multidetector CT (MDCT) may prove useful in patients with suspected gastroduodenal bleeding. […] Endoscopy is the modality of choice for the investigation of hemorrhages, having a sensitivity of more than 90% in the detection of the bleeding site. […] The American College of Radiology (ACR) Appropriateness Criteria include the following imaging recommendations for identifying the source of upper GI bleeding (UGIB): When endoscopy identifies the presence and location of bleeding but bleeding cannot be controlled endoscopically, catheter-based arteriography with treatment is an appropriate next study. CT angiography (CTA) is comparable to angiography as a diagnostic next step.

• #1 Non-perforated peptic ulcer disease: multidetector CT findings, complications, and differential diagnosis | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1007/s13244-017-0562-5

  Despite availability of effective therapies, peptic ulcer disease (PUD) remains a major global disease, resulting from a combination of persistent Helicobacter pylori infection and widespread use of nonsteroidal anti-inflammatory drugs. […] Albeit endoscopy definitely represents the mainstay diagnostic technique, patients presenting to emergency departments with unexplained abdominal pain generally undergo multidetector CT as an initial investigation. […] This pictorial essay aims to provide radiologists with an increased familiarity with CT diagnosis of non-perforated PUD, with emphasis on differential diagnosis. […] Upper digestive endoscopy is definitely the mainstay diagnostic technique for PUD, but is invasive and often unfeasible in urgent conditions unless gastrointestinal bleeding is suspected.

• #1 The value of oral contrast-enhanced gastric ultrasonography in the diagnosis and staging of benign peptic ulcer | Scientific Reports

  https://www.nature.com/articles/s41598-024-68430-7

  We evaluate the value of oral contrast-enhanced gastric ultrasonography (OCUS) by comparing it with conventional gastroscopy in diagnosing and staging benign peptic ulcer. […] OCUS is useful for detecting and staging benign peptic ulcer, and may be considered an alternative method for conventional gastroscopy. […] At present, there are few reports on the ultrasonic diagnosis and staging of BPU. […] Oral contrast-enhanced gastric ultrasonography (OCUS) is a novel contrast-enhanced abdominal ultrasound diagnostic technique under development for diagnosing various GI diseases, including BPU and gastric cancer. […] In this study, we evaluated the feasibility of OCUS as an alternative method for diagnosing and staging BPU by comparing it with conventional gastroscopy. […] The stage of BPU lesions was classified using a six-stage SakitaMiwa classification as follows: active (A1, A2), healing (H1, H2), and scarring (S1, S2). […] In our study, OCUS demonstrates a high detection rate and zero false positive rate, with similar efficacy in ulcers localization to that of gastroscopy. […] In summary, OCUS provides a fast, non-invasive way to detect and stage PU.

• #1 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  The rapid urease test performed on the biopsy specimen provides an accurate, inexpensive means of diagnosing H. pylori infection. […] Eradication of H. pylori is recommended in all patients with PUD. […] First-line therapy should have an eradication rate of more than 80%. […] Test of cure for all patients after therapy is neither cost-effective nor practical. Indications for eradication testing with the urea breath test or stool antigen test include H. pylori associated ulcer, continued dyspeptic symptoms, H. pylori associated MALT lymphoma, and resection for gastric cancer. […] A seven- to 10-day triple drug regimen consisting of a PPI, amoxicillin 1 g, and clarithromycin 500 mg (Biaxin) twice daily has long been the first-line therapy to eradicate H. pylori. […] Compliance and tolerance rates of sequential therapy are similar to those of triple therapy but cost is lower, especially when the cost of failure of first-line therapy is considered. […] The ACG guideline recommends that patients who will be on long-term NSAID therapy be tested for H. pylori infection, and eradication therapy should be given if positive.

• #1 Peptic Ulcer Disease – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/peptic-ulcer-disease

  Diagnosis of peptic ulcer is suggested by patient history and confirmed by endoscopy. […] Endoscopy allows for biopsy or cytologic brushing of gastric and esophageal lesions to distinguish between simple ulceration and ulcerating stomach cancer. […] Endoscopy can also be used to definitively diagnose H. pylori infection, which should be sought when an ulcer is detected. […] Gastrin-secreting cancer and gastrinoma should be considered when there are multiple ulcers, when ulcers develop in atypical locations (eg, postbulbar) or are refractory to treatment, or when the patient has prominent diarrhea or weight loss. Serum gastrin levels should be measured in these patients. […] Diagnose with endoscopy and do tests for H. pylori infection.

• #1 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Perforation occurs in as many as 10% of patients with peptic ulcer disease but is less common in gastric ulcers. […] An upper GI series performed with water-soluble contrast agent may demonstrate the presence and site of the perforation and whether it has sealed. […] The double-contrast technique allows differentiation between benign and malignant gastric ulcers in most cases. […] Features associated with a benign ulcer include projection of the ulcer beyond the healthy lumen on the profile view. […] The crater margins of a malignant ulcer may be irregular and nodular, and the ulcer crater is surrounded by an asymmetrical mass that has an abrupt outer border with the healthy mucosa. […] Ulcer healing is demonstrated at follow-up as a decrease in ulcer size and, often, a change in shape from round to linear. Complete healing or disappearance of the ulcer is usually observed 8 weeks after medical treatment and confirms its benign nature.

• #1 Peptic Ulcer Disease – American College of Gastroenterology

  https://gi.org/topics/peptic-ulcer-disease/

  Peptic Ulcer Disease Overview. The most typical way for ulcers to be diagnosed is by a procedure called an EGD. EGD stands for EsophagoGastroDuodenoscopy. An EGD (also called “upper endoscopy”) is performed by inserting a special lighted camera on a flexible tube into the person’s mouth to look directly into the stomach and the beginning of the small bowel. This flexible camera carefully inspects the most likely areas for ulcers to be located. Ulcers identified during an EGD may be photographed, biopsied and even treated, if bleeding is present. […] Today, the preferred method for diagnosing ulcers is with an EGD given the flexible camera is better able to detect even small ulcers and because it allows for potential treatment at that time if the ulcer is bleeding. An upper GI series can miss small ulcers and also does not allow direct treatment of an ulcer.

• #1 Peptic Ulcer Disease: Causes and Treatment | Doctor

  https://patient.info/doctor/peptic-ulcer-disease

  In patients taking NSAIDs, eradication did not improve the ulcer healing rate but it did halve the number of endoscopically proven ulcers six months later from 18% to 9%. […] […] […] Prognosis1 […] With PPI therapy, duodenal ulcers typically heal within 4 weeks and gastric ulcers within 8 weeks. […] With peptic ulcer disease associated with Helicobacter pylori infection, eradication markedly reduces the risk of recurrent ulceration and may cure duodenal ulcers. […] Lifetime risk of recurrence for gastric ulcers is 60% if the person remains H. pylori positive, but 5% following eradication of H. pylori. […] Lifetime risk of recurrence for duodenal ulcers is 80% if the person remains H. pylori positive, but 5% following eradication of H. pylori. […] About 10% of people with a bleeding peptic ulcer will die, and 25% of people with a perforated peptic ulcer will die.

• #2 Peptic Ulcer Disease: Symptoms, Causes, Treatment & Medication

  https://my.clevelandclinic.org/health/diseases/10350-peptic-ulcer-disease

  Peptic ulcer disease causes open sores in your stomach lining or duodenum (the top of your small intestine). […] You’ll need a diagnosis to make sure you’re treating the right cause. […] If your symptoms and/or risk factors suggest peptic ulcer disease, a healthcare provider will look for the ulcer in your GI tract. They’ll also want to test you for an H. pylori infection. […] Detailed imaging tests, like a CT scan (computed tomography scan) or GI series X-ray exam, can detect larger ulcers. Tests for H. pylori infection include a urea breath test or a stool test. […] For many people, an upper endoscopy exam will provide the final diagnosis. An upper endoscopy (or EGD test) goes inside your upper GI tract with a tiny camera on the end of a long tube. […] During an endoscopy, they can also take a stomach biopsy to test for H. pylori. […] If you have untreated peptic ulcer disease for a long time, ulcers may continuously heal and then start again. […] Your healthcare provider will conduct follow-up tests after treatment to make sure the ulcer has healed, and any infection has cleared.

• #2 Diagnosis of Peptic Ulcers (Stomach or Duodenal Ulcers) – NIDDK

  https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/diagnosis

  Your doctor may ask you about your medical and family history, perform a physical exam, and order tests to diagnose a peptic ulcer, find its cause, and check for complications. […] A physical exam may help a doctor diagnose peptic ulcers or ulcer complications. […] Doctors may order medical tests to help diagnose peptic ulcers, find the cause, and check for complications. […] Doctors may use blood tests to check for signs of H. pylori infection or complications of peptic ulcers. […] Doctors may use a urea breath test to check for H. pylori infection. […] Doctors may use stool tests to check for H. pylori infection. […] Doctors may order an upper GI endoscopy to confirm the diagnosis of a peptic ulcer and try to find its cause. […] In some cases, doctors may order an upper GI series to help diagnose peptic ulcers or ulcer complications.

• #2 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Upper gastrointestinal (GI) endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease. It is highly sensitive for the diagnosis of gastric and duodenal ulcers, allows for biopsies and cytologic brushings in the setting of a gastric ulcer to differentiate a benign ulcer from a malignant lesion, and allows for the detection of H pylori infection with antral biopsies for a rapid urease test and/or histopathology in patients with peptic ulcer disease. […] A fasting serum gastrin level should be obtained in certain cases to screen for Zollinger-Ellison syndrome. […] A secretin stimulation test may be required if the diagnosis of Zollinger-Ellison syndrome cannot be made on the basis of the serum gastrin level alone. […] A single biopsy offers 70% accuracy in diagnosing gastric cancer, but 7 biopsy samples obtained from the base and ulcer margins increase the sensitivity to 99%. […] The emergency department (ED) workup will vary depending on presentation and includes the following: Complete blood cell (CBC) count is used to evaluate acute or chronic blood loss.

• #2 Peptic ulcers: diagnosis and tests – myDr.com.au

  https://mydr.com.au/tests-investigations/peptic-ulcers-diagnosis-and-tests/

  H. pylori can also be detected in a stool sample (poo sample). […] The H. pylori stool antigen test can be done to diagnose infection and to confirm successful treatment of the infection. […] A blood test can also be done for H. pylori. […] Your doctor may recommend blood tests to check for possible complications of peptic ulcers, such as bleeding. […] A full blood count (FBC) can be used to test for anaemia, which is a sign of possible blood loss. […] Previously, special X-rays of the stomach and duodenum were used to diagnose peptic ulcers.

• #2 Peptic Ulcer Disease – Gastrointestinal Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/peptic-ulcer-disease

  Diagnosis of peptic ulcer is suggested by patient history and confirmed by endoscopy. […] Endoscopy allows for biopsy or cytologic brushing of gastric and esophageal lesions to distinguish between simple ulceration and ulcerating stomach cancer. […] Endoscopy can also be used to definitively diagnose H. pylori infection, which should be sought when an ulcer is detected. […] Gastrin-secreting cancer and gastrinoma should be considered when there are multiple ulcers, when ulcers develop in atypical locations (eg, postbulbar) or are refractory to treatment, or when the patient has prominent diarrhea or weight loss. Serum gastrin levels should be measured in these patients. […] Diagnose with endoscopy and do tests for H. pylori infection.

• #2 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). […] The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger than 55 years and the absence of alarm symptoms. Most other patients should undergo upper endoscopy to rule out malignancy and other serious causes of dyspepsia. […] The American College of Gastroenterology (ACG) recommends testing for H. pylori infection in patients with active PUD or history of PUD, dyspepsia symptoms, or gastric MALT lymphoma. […] The test-and-treat strategy for detecting H. pylori is appropriate in patients with dyspepsia and low risk of gastric cancer (age younger than 55 years and no alarm symptoms such as unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of gastrointestinal cancer, overt gastrointestinal bleeding, abdominal mass, iron deficiency anemia, or jaundice).

• #2 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  Endoscopy is recommended for patients who are 55 years or older, or who have alarm symptoms. […] The accuracy of diagnostic tests for H. pylori infection is summarized in Table 2. […] Urea breath tests require the ingestion of urea labeled with the nonradioactive isotope carbon 13 or carbon 14. […] Urea breath testing is one option for test of cure and should be performed four to six weeks after completion of eradication therapy. […] Stool antigen tests using monoclonal antibodies are as accurate as urea breath tests if a validated laboratory-based monoclonal test is used. […] Serologic antibody testing detects immunoglobulin G specific to H. pylori in serum and cannot distinguish between an active infection and a past infection. […] Endoscopy with biopsy is recommended to rule out cancer and other serious causes in patients 55 years or older, or with one or more alarm symptoms.

• #2 Test Diagnoses Peptic Ulcer Disease

  https://www.uspharmacist.com/article/test-diagnoses-peptic-ulcer-disease

  Peptic ulcer disease (PUD) is defined as an erosion in the lining of the stomach or the duodenum. […] Methods of diagnosing H. pylori infection include upper GI tract biopsy, histological examination, rapid urease test, culture, antibody detection, antigen detection, and the urea breath test. When endoscopy is indicated, a histological examination is the diagnostic test of choice. […] The stool antigen and urea breath tests have similar accuracy and are preferred when endoscopy is not clinically indicated. […] BreathTek is an FDA-approved diagnostic device that uses breath samples to detect H. pylori. […] BreathTek is indicated for patients with active PUD, a history of documented PUD, and/or mucosal-associated lymphoid-type lymphoma. […] Data collected from a clinical trial conducted in Europe and the United States indicated that BreathTek was excellent in the detection of H. pylori. […] The diagnostic test that had greatest efficacy was the UBT (sensitivity, 97%; specificity, 100%). […] Indicated for the initial diagnosis and posttreatment monitoring of H. pylori infection, Breath-Tek has demonstrated 95% sensitivity in detecting active infection.

• #2 Peptic Ulcer Disease: Causes and Treatment | Doctor

  https://patient.info/doctor/peptic-ulcer-disease

  […] […] Management of recurrence and its prevention3 […] For gastric ulcer with H. pylori infection, NICE recommends eradication therapy followed by proof of eradication and repeat endoscopy. This is a consensus statement. If eradication is successful but the ulcer unhealed then malignancy needs to be considered. […] Serology tests are applicable only for initial diagnosis, as they remain positive for a long while. […] The situation concerning H. pylori eradication in patients who require long-term NSAIDs is still being researched.17 Currently, several guidelines recommend that any patient who has had a peptic ulcer bleed (PUB) or who is put on long-term NSAIDs should be checked for H. pylori infection.8 […] For patients who have relapses, intermittent therapy and annual review are recommended.

• #2 Peptic Ulcer Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534792/

  Peptic ulcer disease (PUD) is characterized by discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in the stomach and proximal duodenum. […] Today, testing for Helicobacter pylori is recommended in all patients with peptic ulcer disease. Endoscopy may be required in some patients to confirm the diagnosis, especially in those patients with sinister symptoms. […] Diagnosis of PUD requires history taking, physical examination, and invasive/non-invasive medical tests. A careful history should be obtained and noted for the presence of any complications. Patient reporting of epigastric abdominal pain, early satiety, and fullness following a meal raise suspicion of PUD. […] Investigations: Esophagogastroduodenoscopy (EGD): Gold standard and most accurate diagnostic test with sensitivity and specificity up to 90% in diagnosing gastric and duodenal ulcers. […] Anyone with the presence of alarm symptoms should undergo EGD, irrespective of age.

• #2 Peptic Ulcer Disease – Gastric – Duodenal – TeachMeSurgery

  https://teachmesurgery.com/general/gastric/peptic-ulcer/

  At endoscopy, any peptic ulceration seen (Fig. 3) can be biopsied, which will be sent for histology(if looks suspicious for malignancy) and forrapid urease test (CLO test) to determine the presence of H. pylori. […] Any patient with peptic ulcer disease should be given lifestyle adviceto reduce symptoms, such assmoking cessation, weight loss, and reduction in alcohol consumption. […] Patients with suspected or confirmed ulcers can be started on a Proton Pump Inhibitor (PPI, e.g. omeprazole) for 4-6 weeks to reduce acid production. […] Those patients with a positive H. pylori test should be started on triple therapy. […] Any patient with red-flag symptoms or not responding to conservative management should be referred for urgent upper GI endoscopy.

• #2 Stomach Ulcer: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/stomach-ulcer

  According to the NHS, a doctor may prescribe only PPIs if your stomach ulcers are caused by taking NSAIDs. […] You’ll most likely need another endoscopy within 4 to 6 weeks to check whether the stomach ulcer has properly been treated. […] In very rare cases, complicated stomach ulcers will require surgery if they: continue to return, don’t heal, bleed, tear through the stomach, keep food from flowing out of the stomach into the small intestine. […] Surgery may include: removal of the entire ulcer, taking tissue from another part of the intestines and patching it over the ulcer site, tying off a bleeding artery, cutting off the nerve supply to the stomach to reduce the production of stomach acid. […] Speak with a doctor if you experience symptoms like a burning sensation in the abdomen, along with bloating, nausea, and unintentional weight loss. […] They could provide a proper diagnosis and develop a treatment plan for you.

• #2 How Peptic Ulcer Disease Is Diagnosed

  https://www.verywellhealth.com/peptic-ulcer-disease-diagnosis-4707600

  If the cause of peptic ulcers isn’t related to H. pylori, your healthcare provider may perform some imaging tests in order to see the contents of your stomach and intestine. […] With an endoscopy, a small tube with a lens (called an endoscope) is inserted into your throat to view your esophagus, small intestine, and stomach. […] Commonly referred to as a barium swallow, this imaging test is performed if someone is experiencing severe peptic ulcer symptoms, like stomach pain with vomiting, weight loss, or difficulty swallowing. […] For the CT scan, you will drink a solution called a contrast medium, then lay on a table that slides into a tunnel-shaped machine. […] Your healthcare provider may also consider other causes for your symptoms. […] There are several tests available to help diagnose peptic ulcer disease. […] If you think you may have peptic ulcer disease, talk to a healthcare provider to get an accurate diagnosis.

• #2

  https://link.springer.com/article/10.1007/BF01309382

  The introduction of fiberoptic endoscopy has altered the relative importance of ulcer symptoms in the diagnosis of peptic ulcer disease. […] Modern forward-viewing endoscopes of small diameter enable precise diagnosis with little discomfort in 95% of all duodenal ulcer patients. A biopsy is only recommended in rare cases (giant ulcers) because the malignancy rate is only 0.024% in duodenal ulcers. The diagnostic accuracy of endoscopy in detecting gastric ulcer is as high as that for duodenal ulcer, but for this ulcer type it is absolutely necessary to exclude malignancy by obtaining a minimum of six biopsies (four from the ulcer margin and two from the ulcer base), since approximately 10% of all gastric ulcers are actually carcinomas. […] In experienced hands endoscopy is superior to radiography in duodenal and in gastric ulcer, although there is still a place for radiography as a supplementary investigation or if the patient rejects endoscopy. […] When selecting patients for treatment of peptic ulcer the following aspects must be considered: natural history of the disease, effectiveness of treatment, and risks and costs of treatment.

• #2 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Single-contrast barium studies have an overall sensitivity of 75%, but double-contrast barium examinations have a sensitivity as high as 95% in the detection of gastric cancer. These results are comparable to those of endoscopy, and double-contrast barium examination remains a useful alternative to endoscopy. […] Although endoscopy remains the standard of care, multidetector CT (MDCT) may prove useful in patients with suspected gastroduodenal bleeding. […] Endoscopy is the modality of choice for the investigation of hemorrhages, having a sensitivity of more than 90% in the detection of the bleeding site. […] The American College of Radiology (ACR) Appropriateness Criteria include the following imaging recommendations for identifying the source of upper GI bleeding (UGIB): When endoscopy identifies the presence and location of bleeding but bleeding cannot be controlled endoscopically, catheter-based arteriography with treatment is an appropriate next study. CT angiography (CTA) is comparable to angiography as a diagnostic next step.

• #2 Peptic Ulcer Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p1005.html

  A history of episodic or epigastric pain, relief of pain after food intake, and nighttime awakening because of pain with relief following food intake are the most specific findings for peptic ulcer and help rule in the diagnosis. […] Patients older than 55 years and those with alarm symptoms should be referred for prompt upper endoscopy. […] Esophagogastroduodenoscopy (EGD) is more sensitive and specific for peptic ulcer disease than upper gastrointestinal barium studies and allows biopsy of gastric lesions. […] Patients younger than 55 years with no alarm symptoms should be tested for H. pylori infection and advised to discontinue the use of NSAIDs, smoking, alcohol, and illicit drug use. […] If test results are positive for H. pylori, the infection should be eradicated and antisecretory therapy, preferably with a proton pump inhibitor, administered for four weeks. […] Further management is based on the endoscopic or radiologic diagnosis.

• #2 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Testing for H pylori infection is essential in all patients with peptic ulcers. Documentation of peptic ulcer disease depends on radiographic and endoscopic confirmation. […] If the diagnosis of peptic ulcer disease is suspected, obtaining a complete blood cell (CBC) count, liver function tests (LFTs), and levels of amylase and lipase may be useful. […] The 2017 American College of Gastroenterology (ACG) guidelines for the treatment of H pylori infection (HPI) include recommendations for testing for H pylori. […] The 2017 ACG guidelines also recommend posttreatment testing to prove eradication of HPI with the use of a urea breath test, fecal antigen test, or biopsy-based testing at least 4 weeks following the completion of antimicrobial therapy and after proton pump inhibitors have been withheld for 1-2 weeks.

• #2 Stomach Ulcer: Symptoms, Causes, and Treatment

  https://patient.info/digestive-health/dyspepsia-indigestion/stomach-ulcer-gastric-ulcer

  Stomach ulcer diagnosis involves several tests. […] The main tests that are used to diagnose a stomach ulcer are as follows: […] A test to detect the H. pylori bacteria can be conducted using a sample of stool or from a biopsy sample taken during a gastroscopy. […] Blood tests can look for anaemia because of any bleeding from the ulcer. […] A gastroscopy is the definitive test for a stomach ulcer. During a gastroscopy, a clinician looks inside the stomach by passing a thin, flexible telescope down the oesophagus. […] Samples (biopsies) are usually taken of the tissue in and around the ulcer during gastroscopy. These are sent to the laboratory to be looked at under the microscope. […] This is important because some ulcers are caused by stomach cancer. Most stomach ulcers are not caused by cancer and can be completely treated with medication.

• #2 Stomach Ulcer: Signs, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22314-stomach-ulcer

  A stomach ulcer occurs when stomach acid eats through your protective stomach lining, producing an open sore. […] A healthcare provider must identify the cause of your ulcer to recommend the right treatment. […] Your healthcare provider will begin by asking you about your symptoms and medical history. […] If signs point to an ulcer, theyll take a look inside your stomach to find it. […] Your healthcare provider will want to check for H. pylori infection, then look for the ulcer itself inside your stomach. […] One common method is an upper endoscopy exam, which can accomplish both at once. […] An upper endoscopy (EGD test) goes inside your stomach with a tiny camera on a long, thin tube (endoscope). […] Your provider can use these tools to take a tissue sample (biopsy) and test it for H. pylori.

• #2 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Perforation occurs in as many as 10% of patients with peptic ulcer disease but is less common in gastric ulcers. […] An upper GI series performed with water-soluble contrast agent may demonstrate the presence and site of the perforation and whether it has sealed. […] The double-contrast technique allows differentiation between benign and malignant gastric ulcers in most cases. […] Features associated with a benign ulcer include projection of the ulcer beyond the healthy lumen on the profile view. […] The crater margins of a malignant ulcer may be irregular and nodular, and the ulcer crater is surrounded by an asymmetrical mass that has an abrupt outer border with the healthy mucosa. […] Ulcer healing is demonstrated at follow-up as a decrease in ulcer size and, often, a change in shape from round to linear. Complete healing or disappearance of the ulcer is usually observed 8 weeks after medical treatment and confirms its benign nature.

• #3 Peptic Ulcer Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534792/

  Peptic ulcer disease (PUD) is characterized by discontinuation in the inner lining of the gastrointestinal (GI) tract because of gastric acid secretion or pepsin. It extends into the muscularis propria layer of the gastric epithelium. It usually occurs in the stomach and proximal duodenum. […] Today, testing for Helicobacter pylori is recommended in all patients with peptic ulcer disease. Endoscopy may be required in some patients to confirm the diagnosis, especially in those patients with sinister symptoms. […] Diagnosis of PUD requires history taking, physical examination, and invasive/non-invasive medical tests. A careful history should be obtained and noted for the presence of any complications. Patient reporting of epigastric abdominal pain, early satiety, and fullness following a meal raise suspicion of PUD. […] Investigations: Esophagogastroduodenoscopy (EGD): Gold standard and most accurate diagnostic test with sensitivity and specificity up to 90% in diagnosing gastric and duodenal ulcers. […] Anyone with the presence of alarm symptoms should undergo EGD, irrespective of age.

• #3 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Testing for H pylori infection is essential in all patients with peptic ulcers. Documentation of peptic ulcer disease depends on radiographic and endoscopic confirmation. […] If the diagnosis of peptic ulcer disease is suspected, obtaining a complete blood cell (CBC) count, liver function tests (LFTs), and levels of amylase and lipase may be useful. […] The 2017 American College of Gastroenterology (ACG) guidelines for the treatment of H pylori infection (HPI) include recommendations for testing for H pylori. […] The 2017 ACG guidelines also recommend posttreatment testing to prove eradication of HPI with the use of a urea breath test, fecal antigen test, or biopsy-based testing at least 4 weeks following the completion of antimicrobial therapy and after proton pump inhibitors have been withheld for 1-2 weeks.

• #3 A pilot study of non-invasive diagnostic tools to detect Helicobacter pylori infection and peptic ulcer disease | Scientific Reports

  https://www.nature.com/articles/s41598-023-50266-2

  Helicobacter pylori (H. pylori) infection can lead to various digestive system diseases, making accurate diagnosis crucial. […] This study aimed to compare the efficacy of non-invasive and invasive diagnostic tools for H. pylori infection and assess their correlation with esophagogastroduodenoscopic (EGD) findings. […] The study utilized the Campylobacter-Like Organism (CLO) test, serum anti-HP IgG blood test, and C-13-urea breath test (UBT) to diagnose H. pylori infection. […] Each diagnostic test and any combination of two positive tests were considered the reference standard and compared against the other diagnostic methods. […] The UBT demonstrated the highest Youden’s index, ranging from 58 to 100%, against all the non-invasive tests. […] The IgG blood test displayed the highest sensitivity at 100%, with a specificity of 60-70%.

• #3

  https://www.nhs.uk/conditions/stomach-ulcer/diagnosis/

  If a GP thinks you have a stomach ulcer, you may be tested for an Helicobacter pylori (H. pylori) infection. […] You may be referred to hospital for a procedure to look inside your stomach called a gastroscopy. […] If your GP thinks your symptoms are caused by an H. pylori infection, they may recommend one of the following tests: a urea breath test you’ll be given a drink containing urea (a chemical that’s broken down by H. pylori) and your breath is then checked after, a stool antigen test a small stool sample is tested for the bacteria, 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 to fight infection); this has now largely been replaced by the stool antigen test. […] If you test positive for H. pylori, you’ll need treatment to clear it, which can heal the ulcer and prevent it returning. […] This is a test to look inside your stomach directly and see whether you have a stomach ulcer. […] The images taken by the camera will usually confirm or rule out an ulcer. A small tissue sample may also be taken from your stomach or duodenum so it can be tested for the H. pylori bacteria.

• #3 Peptic Ulcer Disease Workup: Approach Considerations, Endoscopy, Radiography

  https://emedicine.medscape.com/article/181753-workup

  Upper gastrointestinal (GI) endoscopy is the preferred diagnostic test in the evaluation of patients with suspected peptic ulcer disease. It is highly sensitive for the diagnosis of gastric and duodenal ulcers, allows for biopsies and cytologic brushings in the setting of a gastric ulcer to differentiate a benign ulcer from a malignant lesion, and allows for the detection of H pylori infection with antral biopsies for a rapid urease test and/or histopathology in patients with peptic ulcer disease. […] A fasting serum gastrin level should be obtained in certain cases to screen for Zollinger-Ellison syndrome. […] A secretin stimulation test may be required if the diagnosis of Zollinger-Ellison syndrome cannot be made on the basis of the serum gastrin level alone. […] A single biopsy offers 70% accuracy in diagnosing gastric cancer, but 7 biopsy samples obtained from the base and ulcer margins increase the sensitivity to 99%. […] The emergency department (ED) workup will vary depending on presentation and includes the following: Complete blood cell (CBC) count is used to evaluate acute or chronic blood loss.

• #3 Gastric Ulcer Imaging: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/368602-overview

  Peptic ulcers are mucosal breaks of 3 mm or greater and are common, occurring in about 10% of adults in Western countries. Gastric ulcers account for about one third of peptic ulcers, and duodenal ulcers account for the remainder. Because a small percentage (5%) of gastric ulcers are caused by ulcerated gastric carcinomas, all gastric ulcers must be carefully assessed to differentiate benign lesions from malignant lesions. […] Fiberoptic endoscopy of the upper GI tract has become the diagnostic procedure of choice for patients with suspected duodenal ulcer. However, endoscopic examinations are more invasive and costly than double-contrast barium studies. Endoscopy with biopsy has a sensitivity of 95%, but multiple biopsy samples are needed to avoid sampling errors. […] The American Society of Gastrointestinal Endoscopy (ASGE) has published guidelines regarding endoscopy in patients with upper abdominal pain or dyspeptic symptoms that suggest peptic ulcer disease. The ASGE suggests that the decision to perform surveillance endoscopy in patients with a gastric ulcer be individualized. Surveillance endoscopy is suggested for patients with gastric ulcer who remain symptomatic despite an appropriate course of medical therapy.

• #3 Peptic Ulcer Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p1005.html

  A history of episodic or epigastric pain, relief of pain after food intake, and nighttime awakening because of pain with relief following food intake are the most specific findings for peptic ulcer and help rule in the diagnosis. […] Patients older than 55 years and those with alarm symptoms should be referred for prompt upper endoscopy. […] Esophagogastroduodenoscopy (EGD) is more sensitive and specific for peptic ulcer disease than upper gastrointestinal barium studies and allows biopsy of gastric lesions. […] Patients younger than 55 years with no alarm symptoms should be tested for H. pylori infection and advised to discontinue the use of NSAIDs, smoking, alcohol, and illicit drug use. […] If test results are positive for H. pylori, the infection should be eradicated and antisecretory therapy, preferably with a proton pump inhibitor, administered for four weeks. […] Further management is based on the endoscopic or radiologic diagnosis.

• #3

  https://link.springer.com/article/10.1007/BF01309382

  The introduction of fiberoptic endoscopy has altered the relative importance of ulcer symptoms in the diagnosis of peptic ulcer disease. […] Modern forward-viewing endoscopes of small diameter enable precise diagnosis with little discomfort in 95% of all duodenal ulcer patients. A biopsy is only recommended in rare cases (giant ulcers) because the malignancy rate is only 0.024% in duodenal ulcers. The diagnostic accuracy of endoscopy in detecting gastric ulcer is as high as that for duodenal ulcer, but for this ulcer type it is absolutely necessary to exclude malignancy by obtaining a minimum of six biopsies (four from the ulcer margin and two from the ulcer base), since approximately 10% of all gastric ulcers are actually carcinomas. […] In experienced hands endoscopy is superior to radiography in duodenal and in gastric ulcer, although there is still a place for radiography as a supplementary investigation or if the patient rejects endoscopy. […] When selecting patients for treatment of peptic ulcer the following aspects must be considered: natural history of the disease, effectiveness of treatment, and risks and costs of treatment.

• #3 Peptic Ulcer Disease: Causes and Treatment | Doctor

  https://patient.info/doctor/peptic-ulcer-disease

  […] […] Management of recurrence and its prevention3 […] For gastric ulcer with H. pylori infection, NICE recommends eradication therapy followed by proof of eradication and repeat endoscopy. This is a consensus statement. If eradication is successful but the ulcer unhealed then malignancy needs to be considered. […] Serology tests are applicable only for initial diagnosis, as they remain positive for a long while. […] The situation concerning H. pylori eradication in patients who require long-term NSAIDs is still being researched.17 Currently, several guidelines recommend that any patient who has had a peptic ulcer bleed (PUB) or who is put on long-term NSAIDs should be checked for H. pylori infection.8 […] For patients who have relapses, intermittent therapy and annual review are recommended.

• #3 Ulcers | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/u/ulcers.html

  A doctor usually bases a diagnosis of peptic ulcer on the patient’s history. A physician will want to rule out the presence of stomach cancer, which can have similar symptoms. This is especially true in patients who are older, have lost weight, have severe symptoms or do not respond to treatment. […] The diagnosis can be confirmed through a variety of studies, such as: Endoscopy, which uses a camera attached to the end of a flexible tube to allow the doctor to see inside the body. This can reliably detect swelling and irritation (inflammation) of the esophagus and esophageal ulcers as well as H. pylori infection. […] Barium swallow […] Cytology (examination under a microscope of cells from the affected area) […] Multiple biopsies […] X-rays or CT scans to identify ulcers that have caused holes in the stomach or intestines.

• #3 Helicobacter pylori (H. pylori) infection – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/h-pylori/diagnosis-treatment/drc-20356177

  Several tests and procedures are used to determine whether you have Helicobacter pylori (H. pylori) infection. […] Testing is important for detection of Helicobacter pylori (H. pylori). […] Repeat testing after treatment is important to be sure H. pylori is gone. […] Tests may be done using a stool sample, through a breath test and by an upper endoscopy exam. […] A health care provider may conduct a scope test, known as an upper endoscopy exam. […] Your provider may perform this test to investigate symptoms that may be caused by conditions such as a peptic ulcer or gastritis that may be due to H. pylori. […] This test may be repeated after treatment, depending on what is found at the first endoscopy or if symptoms continue after H. pylori infection treatment. […] The same tests used for diagnosis can be used to tell if H. pylori infection is gone. […] Repeat testing for H. pylori at least four weeks after your treatment is recommended. […] If the tests show the treatment didn’t get rid of the infection, you may need more treatment with a different combination of antibiotics.

• #3 Peptic ulcers: diagnosis and tests – myDr.com.au

  https://mydr.com.au/tests-investigations/peptic-ulcers-diagnosis-and-tests/

  Your doctor may suspect a peptic ulcer based on your symptoms and whether you have any risk factors. […] To help make a diagnosis, your doctor will want to do a physical examination and organise tests to look for signs of peptic ulcers or any complications that may have developed. […] A gastroscopy can be done to confirm a diagnosis of peptic ulcer. […] If they find an ulcer, they may take some tissue samples (biopsies). The biopsy samples can be tested for the presence of Helicobacter pylori (H. pylori) the cause of many peptic ulcers. […] There are also several non-invasive tests that can detect an infection with H. pylori. […] If the tests confirm you have H. pylori infection, your doctor will prescribe treatment to eradicate the infection. […] The H. pylori breath test (also called the urea breath test) is an accurate test that can determine whether you have H. pylori in your stomach or duodenum.

• #3 Stomach Ulcer: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/stomach-ulcer

  According to the NHS, a doctor may prescribe only PPIs if your stomach ulcers are caused by taking NSAIDs. […] You’ll most likely need another endoscopy within 4 to 6 weeks to check whether the stomach ulcer has properly been treated. […] In very rare cases, complicated stomach ulcers will require surgery if they: continue to return, don’t heal, bleed, tear through the stomach, keep food from flowing out of the stomach into the small intestine. […] Surgery may include: removal of the entire ulcer, taking tissue from another part of the intestines and patching it over the ulcer site, tying off a bleeding artery, cutting off the nerve supply to the stomach to reduce the production of stomach acid. […] Speak with a doctor if you experience symptoms like a burning sensation in the abdomen, along with bloating, nausea, and unintentional weight loss. […] They could provide a proper diagnosis and develop a treatment plan for you.

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