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Diagnosing Peptic Ulcers

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Updated June 04, 2012

Testing for Bacterial Infection

Most peptic ulcers are caused by a bacteria known as H. Pylori. Confirming the presence of H. pylori is important because elimination of the bacteria is likely to cure the ulcer.

Any number of blood, breath, and stomach tissue tests may be performed to detect the presence of H. pylori. None of the tests are foolproof -- blood tests on occasion give false positive results, and the other tests may give false negative results in people who have recently taken antibiotics, omeprazole (Prilosec), or bismuth (Pepto-Bismol).

Blood Tests

Blood tests such as the enzyme-linked immunosorbent assay (ELISA) and quick office-based tests identify and measure H. pylori antibodies. The body produces antibodies against H. pylori in an attempt to fight the bacteria. Blood tests are inexpensive and easy to use for doctors. However, the disadvantage is that there is an increased risk of getting a false-positive test, especially in people who have had an H. pylori infection in the past.

Breath Tests

Breath tests measure the amount of carbon dioxide in exhaled breath. Patients are given a substance called urea with carbon to drink. Bacteria break down this urea and the carbon is absorbed into the blood stream and lungs, and exhaled in the breath. By collecting the breath, doctors can measure this carbon and determine whether H. pylori is present or absent. Urea breath tests are at least 90 percent accurate for diagnosing the bacteria and are particularly suitable to follow-up treatment to see if bacteria have been eradicated.

Tissue Tests

If the doctor performs an endoscopy to diagnose an ulcer, tissue samples of the stomach can be obtained. The doctor may then perform one of several tests on the tissue. First, a rapid urease test detects the presence of bacterial enzymes. Second, the bacteria can be examined under a microscope, and growing the organisms in a laboratory (bacterial culture) can allow a doctor to more definitively find out if the bacteria is H. pylori.

Barium X-rays

Barium x-rays (also referred to as a Barium Swallow) is an examination of the esophagus and stomach using a solution with barium. The patient drinks the solution, which coat the walls of the upper digestive tract so that they may be examined under x- ray. Barium swallows are used to identify ulcers, and any abnormalities of the upper gastrointestinal tract such as tumors, hernias, pouches, strictures, and swallowing difficulties. However, the presence of H. Pylori cannot be detected from the barium x-ray alone.

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Sources:
"Common GI Problems: Volume 1." American College of Gastroenterology. 22 Aug 2007

"H. pylori and Peptic Ulcer." NIH Publication No. 05–4225 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

"What I need to know about Peptic Ulcers." NIH Publication No. 05–5042 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

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