Your GP may suspect that you have an ulcer based on your symptoms. In most cases they will then either treat you with an acid-suppressing medication or test for H. pylori and treat it, or both.
You may be referred for an endoscopy to look inside your stomach directly to see whether you have a stomach ulcer.
The procedure (called a diagnostic gastroscopy) is carried out in hospital and involves passing a thin, flexible tube (an endoscope) with a camera at one end into your mouth, through your gullet and into your stomach and duodenum.
The images taken by the camera will usually confirm or exclude an ulcer without the need for further tests.
During the procedure the specialist may also take a tissue sample from your stomach or duodenum. The sample can then be tested for the H. pylori bacteria.
A diagnostic gastroscopy isn't painful but some people find the experience uncomfortable. You can have your throat numbed with a local anaesthetic spray or you can be sedated.
Sedation makes you very drowsy so that you have little or no awareness of the gastroscopy being carried out. If you choose to have sedation, you will need to arrange for someone to give you a lift home after the procedure and to stay with you for at least 12 hours afterwards.
If you decide to have a local anaesthetic, you can leave hospital as soon as the procedure has been completed. You can resume normal activities within one-to-two hours.
Read more about diagnostic gastroscopy.
Diagnosing H. pylori infection
If your GP thinks that your symptoms may be due to an H. pylori infection (which would usually be the case if you don't have recent history of taking non-steroidal anti-inflammatory drugs), you may need to have one of several possible further tests. These are described below.
- A urea breath test – you will be given a special drink that contains a chemical that is digested by H. pylori. Analysis of your breath after having the drink indicates whether or not you have an H. pylori infection.
- A stool antigen test – a pea-sized stool sample will be tested.
- A blood test – a sample of your blood will be tested for antibodies to the H. pylori bacteria. Antibodies are proteins that are produced naturally in your blood and help fight infection.
If you test positive for H. pylori, you will need treatment to clear the infection. This can heal the ulcer and, even more importantly, prevent it from coming back.
Read more about treating stomach ulcers.
