How is it Diagnosed?
Peptic ulcers are open sores that develop on the inner lining of the stomach (gastric
ulcers) or the upper portion of the small intestine (duodenal ulcers). The diagnosis
begins with a detailed clinical history, including symptoms such as burning epigastric
pain, bloating, nausea, or early satiety. Pain that improves or worsens with eating can
help differentiate gastric from duodenal ulcers.
A physical examination may reveal mild tenderness in the epigastric region. However,
definitive diagnosis requires investigations. The urea breath test, stool antigen test, or
blood test for Helicobacter pylori is commonly used since H. pylori infection is a major
causative factor.
Upper gastrointestinal (GI) endoscopy is the gold standard for diagnosis. It allows direct
visualization of the ulcer and biopsy if needed, especially to rule out malignancy in
gastric ulcers. In some cases, a barium swallow X-ray may be used, although it is less
commonly preferred due to lower sensitivity.
In patients taking NSAIDs, correlation with medication history is critical. Further
investigations like complete blood count (CBC) may detect anemia if there’s chronic
bleeding. In complicated cases (e.g., perforation), imaging like abdominal X-ray or CT
scan helps identify free air or inflammation.