Stomach Ulcers: Hospital Diagnosis And Treatment Options

Stomach ulcers are open sores that develop on the stomach lining, and they can cause symptoms like abdominal pain, nausea, and a burning sensation in the stomach. To diagnose a stomach ulcer, healthcare providers will first ask about symptoms and medical history, including medication use and any history of H. pylori infection, which is the most common cause of stomach ulcers. If an ulcer is suspected, there are several tests available to confirm the diagnosis, including breath tests, blood tests, and stool tests for H. pylori infection, as well as imaging tests like X-rays and endoscopies, which involve inserting a thin tube with a camera into the patient's throat to visualize the stomach directly.

Patient symptoms and medical history

When diagnosing a stomach ulcer, a healthcare provider will begin by asking about a patient's symptoms and medical history. The patient's symptoms may include a burning sensation in the middle of the stomach that gets worse when the stomach is empty, abdominal pain, nausea, and a dull or burning pain in the belly between the breastbone and belly button. These symptoms can last from a few minutes to a few hours and may occur between meals or at night. It is important to note that symptoms of a stomach ulcer can be similar to those of other conditions, such as food poisoning, appendicitis, gall bladder issues, or inflammation in the intestines. Therefore, a proper diagnosis by a healthcare professional is crucial.

During the evaluation, the healthcare provider will inquire about the patient's medical history, including any past occurrences of peptic ulcers or Helicobacter pylori (H. pylori) infections. H. pylori is a common bacterial infection that affects up to half of the world's population and is one of the leading causes of stomach ulcers. The provider will also ask about the patient's medication usage, especially the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin, or naproxen. These medications can irritate the stomach lining and are another common cause of stomach ulcers.

The patient's family history is also relevant, and the healthcare provider may ask about any history of peptic ulcers, H. pylori infections, or cancer in the digestive tract. Additionally, the patient may be asked about their dietary habits and lifestyle factors, such as smoking, alcohol consumption, and caffeine intake, as these can impact the symptoms and healing process of stomach ulcers.

Based on the patient's symptoms and medical history, the healthcare provider will then determine the appropriate tests and treatments for stomach ulcers. It is important to seek medical attention if one suspects they have a stomach ulcer to ensure proper diagnosis and timely treatment.

Physical examination

If you suspect you have a stomach ulcer, it is important to see a doctor. A primary care doctor can diagnose and prescribe treatment for a stomach ulcer. They will first ask you about your symptoms, medical history, and medications you take. They will then conduct a physical examination.

During a physical examination for a suspected stomach ulcer, the doctor will look for signs of an ulcer. They may palpate your abdomen to check for any tenderness or pain and listen to your abdominal sounds with a stethoscope. They may also examine your vital signs, including blood pressure, heart rate, and temperature. The physical examination helps the doctor determine the location and severity of the ulcer and rule out other possible causes of your symptoms.

The doctor may also perform a neurological examination to assess your neurological function, including your reflexes, coordination, and sensory function. This is to evaluate if there is any nerve involvement associated with the ulcer. Additionally, they may perform a rectal examination to check for any blood in the stool, which could indicate gastrointestinal bleeding.

A physical examination is an important part of the diagnostic process for stomach ulcers. It provides valuable information that, along with your medical history and symptoms, helps the doctor make an informed decision about further testing and treatment options. It is always advisable to seek medical attention if you suspect you have a stomach ulcer to ensure prompt diagnosis and appropriate care.

Stool, blood, or breath tests

Hospitals can check for stomach ulcers using stool, blood, or breath tests. These tests are typically carried out after an evaluation of symptoms and medical history, and they specifically look for the presence of the H. pylori bacteria, which causes around 99% of stomach ulcers.

Stool Tests

For a stool test, a patient will be given a container to collect a stool sample. This sample is then sent to a lab for testing, which will show the presence of H. pylori bacteria. This test typically takes 2-3 days for results.

Blood Tests

Blood tests are used to check for infection-fighting cells, or antibodies, that indicate the presence of H. pylori. Blood tests can also check for low blood count, which may be a sign of bleeding from an ulcer.

Breath Tests

The urea breath test is used to check for H. pylori. The patient swallows a urea pill containing carbon molecules, and if H. pylori is present, the bacteria will break down the urea and release carbon dioxide. This is then detected on the exhaled breath.

These tests are often used in conjunction with an endoscopy, which involves passing a thin tube with a camera down the patient's throat to visually inspect the stomach for ulcers and take a tissue sample for further analysis.

Upper endoscopy

The endoscope is equipped with a tiny camera that allows the doctor to visually examine the lining of these organs for any signs of ulcers or inflammation. During the procedure, the patient is usually sedated to ensure comfort and minimise discomfort.

The procedure is typically performed on an outpatient basis, meaning the patient does not need to stay overnight in the hospital. Upper endoscopy is considered a safe and effective method for diagnosing stomach ulcers and can also be used to treat ulcers by directly visualising and treating the affected area.

In addition to diagnosing stomach ulcers, upper endoscopy can also help identify other conditions affecting the upper GI tract, such as inflammation, bleeding, or blockages. It is often recommended when other non-invasive tests, such as breath, stool, or blood tests, are inconclusive or when a more detailed visualisation of the upper GI tract is required.

Biopsy

A gastric tissue biopsy is a procedure to diagnose a range of stomach issues, including stomach ulcers. It involves removing a small sample of stomach tissue for examination. Typically, a doctor will perform a gastric tissue biopsy when they have been unable to detect the cause of a stomach problem after an initial physical exam, breath test, or blood test.

During the procedure, the patient lies on their left side. The doctor will insert a thin, flexible tube with a light and camera at the end (an endoscope) through the patient's mouth, down the food pipe, and into the stomach. They will pump small amounts of air alongside the endoscope to expand the area, which allows the doctor to see the tissue better. The doctor will look for areas that appear abnormal and collect one or more samples of tissue using small instruments. The endoscopy usually lasts for about 5–20 minutes.

The tissue samples are then sent directly to a laboratory for examination. The samples are placed in a special dish (a Petri dish) to see if bacteria or other organisms grow. The tests involve determining whether certain types of bacteria, such as Helicobacter pylori (H. pylori) bacteria, which are a common cause of stomach ulcers and digestive problems, are present. The tests can also check for cancerous cells and signs of inflammation.

The recovery time is relatively quick, and patients will often return home the same day.

Frequently asked questions