Ulcers

Diagnosis

Patients complaining of stomach ulcer symptoms should receive an H. pylori test. A breath test or blood test can determine if you have H. pylori. Both tests may be done in a doctor's office. For the breath test, you fast for several hours, ingest a special test substance, and breathe into a container. The blood test detects a substance that your body produces in response to bacteria (antibodies). However, if you have recently been treated for an ulcer, this test may not be effective for you. The antibodies from the previous ulcer may linger for months after drug treatment, so if you have recently received treatment for an ulcer, having this test is likely to result detect antibodies to a former infection that is no longer present.

An upper gastrointestinal (GI) tract x-ray study can help identify whether an ulcer exists and where it is located. You will drink a chalky substance called barium to line the digestive tract and make it visible on film. X-rays are then taken. The images show the outline of the stomach and upper intestine. Active ulcers and scarring from previous ulcers will look different from normal tissue.

An endoscopy provides doctors with the most complete information about your ulcer. During the exam, the doctor inserts a long, thin instrument with a tiny camera on the end through your mouth into your stomach and into the duodenum. The tool lights the area and allows the doctor to view the ulcer and the condition of the lining, and to take samples for laboratory analysis. For the procedure your throat is numbed by spraying a topical anaesthetic and you will usually receive a sedative and a pain medication. The procedure can be uncomfortable although minimally, and is expensive. But endoscopy provides a direct visualization of the lining of the food pipe (esophagus), the stomach and the duodenum. An endoscopy may be done after treatment to assess the therapy's effectiveness for healing of the ulcer if your doctor thinks it is necessary. In case you are experiencing problem with swallowing, vomiting blood, losing weight or losing blood in stool endoscopy is the diagnostic method of choice.

Blood tests and testing a stool specimen for blood can help detect if your ulcer is bleeding. A complete blood count is used to assess for anemia. Blood in the stool is often not visible. Hidden blood will show up by testing a small stool specimen.

Prevention and Screening

Even though the exact mechanism of how H. pylori is spread remains unknown, there are several things you can do to lower your risk of ulcer.

• Wash your hands before fixing food or eating.
• Drink water from a clean source.
• Eat food prepared under sanitary conditions.
• Drink fewer than three cups of coffee per day.

Most ulcers caused by nonsteroidal anti-inflammatory drugs can be prevented by taking an additional medication, taking only a low dose of an NSAID or by switching to a different drug. Your doctor might order a second medication, such as misoprostol (Cytotec) to take with an NSAID, which can lower your risk of developing an ulcer. Taking the lowest NSAID dosage that provides relief helps decrease the chance of developing an ulcer. Discontinue the drugs as soon as possible. Some people find other medications provide similar relief. Discuss the risks and alternatives with your doctor.