Diagnosing Peptic Ulcer

Medical history and a physical examination are usually the preliminary check and followed by some of these diagnostic tests.

1. Laboratory test for H. pylori

Although not all peptic ulcers are caused by H. pylori bacteria, testing for H. pylori is a common procedure if patients show symptoms of peptic ulcer. There are four tests to detect H. pylori in the body  ̶  blood test, breath test, stool test and tissue test.

i) Blood test

The immune system produces antibodies to fight H. pylori bacteria when they invade the body. A blood test checks for these antibodies. This test is inexpensive, generally inaccurate and may yield positive results even in people with a history of treated ulcers.

ii) Breath test

A breath test checks for the presence of H. pylori bacteria by measuring carbon in the breath. The patient drinks a liquid with radioactive carbon, which would be broken down if there were H. pylori in the body. The amount of carbon in the blood would elevate and if H. pylori is present, the exhaled breath will contain radioactive carbon dioxide. A sample breath is collected by exhaling into a bag which would then be sealed. This test is more accurate than the blood test and is often used to confirm the success of H. pylori eradication after treatment.

iii) Stool test

A stool sample is collected to check for the presence of H. pylori antigens in the gastrointestinal tract. Antigens are foreign substances that induce an immune response in the body to fight the infection.  This test can be used to diagnose H. pylori infection and to determine if the treatment for the infection has been successful.

iv) Tissue test/Endoscopy

Tissue test via endoscopy is the most accurate test for H. pylori infection. It involves a small flexible tube with a minute camera at the end being inserted through the mouth to examine the stomach and duodenum lining for ulcer and collecting tissue samples. Any ulcer detected during the examination would call for a follow-up endoscopy after treatment to ensure complete healing, even if the symptoms have been relieved..

Endoscopy is especially recommended for patients over 55, have blood in stool, recent weight loss, or difficulty swallowing, as they are at higher risk of stomach cancer.

Endoscopy

2. Upper gastrointestinal series

The upper gastrointestinal series, also known as barium swallow, involves drinking a white liquid (barium) to coat the digestive tract for clearer imaging of ulcers. X-rays of the oesophagus, stomach, and small intestine are then taken for diagnosis. This method is less commonly used.

Preventing Peptic Ulcer

Adopting a healthy lifestyle and habits can reduce the risk of developing a peptic ulcer.

• Avoid infection – Wash hands frequently and consume foods that have been thoroughly cooked
• Avoid or limit the use of NSAIDs – Take NSAIDs with food to decrease the risk of irritating stomach lining
• Stop smoking and other tobacco use
• Reduce stress with regular exercise and mind-body relaxation techniques such as yoga or tai chi
• Avoid alcohol or limit to not more than two alcoholic drinks a day
• Do not mix alcohol with medications
• Avoid or consume caffeine in moderation
• Maintain a healthy and balanced diet rich in fruits, vegetables and whole grains
• Avoid eating large meals which may trigger an excessive production of gastric acid to aid digestion
• Reduce foods that irritate stomach, e.g. citrus fruits. spicy and fatty foods
• Reduce sodium intake or foods high in sodium, e.g. canned soup, potato chips, salted nuts, salted meats, etc
• Increase omega-3 fatty acids in your diet by taking oily fish like salmon, mackerel, sardines and herring. These omega-3 fatty acids could increase the production of prostaglandins – a lipid that protects the lining of the whole digestive passage, including the stomach and intestines
• Take vitamin E from foods such as hazelnuts and cold-pressed sunflower seed oil as well as zinc from seafood and whole grains.