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Health Information

Diagnosis of Peptic Ulcers

Peptic ulcers can be diagnosed using both x-ray and endoscopic examinations. Specialized blood, breath, and stool tests are used to identify the presence of Helicobacter pylori . Rectal examination and stool guaiac test can reveal whether you have a bleeding ulcer.

Endoscopy —This is an examination of the lining of your gastrointestinal tract. After sedation or numbing of the throat, a small tube with a light and camera on the end will be passed into your mouth, down your throat, and into your esophagus, stomach, and duodenum. Other instruments can be passed down through the endoscope to inspect the area, take biopsy samples, and treat any bleeding that is present.

Barium Swallow /Upper GI X-ray Examination —You will be asked to drink a chalky solution containing barium. This coats your digestive tract and helps ensure that x-ray images of your gastrointestinal tract are well detailed. Multiple x-rays are taken before, while, and after you drink the barium.

Blood Tests —If you’re suspected of having a peptic ulcer, you’ll probably have a complete blood count to check for anemia. Anemia is common for an untreated bleeding ulcer. Rapid tests performed right in your doctor’s office may also be used to identify the presence of H. pylori . Blood may also be sent to a laboratory to run more sophisticated tests that can confirm the presence of H. pylori .

Stool Tests for H. Pylori —A tiny sample of stool may be obtained through a rectal examination done in your doctor’s office. The stool sample is tested for the presence of H. pylori . This test can also be used to check for response to antibiotic treatment against H. pylori .

Breath Tests for H. Pylori —You’ll be given a special drink, a capsule, or a pudding containing urea with carbon along with a special radioactive label. After this, you’ll be asked to blow up a balloon or breathe into a bottle of water so that your breath can be collected. If your breath sample contains the radioactively labeled carbon dioxide, this indicates that you have an H. Pylori infection.

Stool Guaiac —A small sample of stool may be obtained through a rectal examination, or after a bowel movement. It’s smeared onto a little card, and several drops of a chemical are dropped onto the stool sample. This can reveal whether blood is present in your stool, which can be a sign of a bleeding ulcer.

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 03/2014 -
  • Update Date: 05/08/2014 -
  • H. pylori and peptic ulcers. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.aspx. Updated April 30, 2012. Accessed April 29, 2013.

  • Meurer LN, Bower DJ. Management of Helicobacter pylori infection. Am Fam Physician. 2002;65(7):1327-36.

  • Peptic ulcer disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 22, 2013. Accessed April 29, 2013.

  • Understanding peptic ulcer disease. American Gastroenterological Association website. Available at: http://www.gastro.org/patient-center/digestive-conditions/peptic-ulcer-disease. Published April 23, 2010. Accessed April 29, 2013.