If you have any of these symptoms, call your doctor right away:

  1. Sharp, sudden, persistent stomach pain.
  2. Bloody or black stools.
  3. Bloody vomit or vomit that looks like coffee grounds. They could be signs of a serious problem, such as:
  4. Perforation-when the ulcer burrows through the stomach or duodenal wall.
  5. Bleeding-when acid or the ulcer breaks a blood vessel.
  6. Obstruction-when the ulcer blocks the path of food trying to leave the stomach.

How Is an H. pylori-related Ulcer Diagnosed?

Diagnosing an Ulcer

To see if symptoms are caused by an ulcer, the doctor may do an upper gastrointestinal (GI) series or an endoscopy. An upper GI series is an x-ray of the esophagus, stomach, and duodenum. The patient drinks a chalky liquid called barium to make these organs and any ulcers show up more clearly on the x-ray.

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An endoscopy is an exam with an endoscope, a thin, lighted tube with a tiny camera on the end. The patient is lightly sedated, and the doctor carefully eases the endoscope through the patient’s mouth and down the throat to the stomach and duodenum. This allows the doctor to see the lining of the esophagus, stomach, and duodenum. The doctor can use the endoscope to take photos of ulcers or remove a tiny piece of tissue to view under a microscope.

Diagnosing H. pylori

If an ulcer is found, the doctor will test the patient for H. pylori. This test is important because treatment for an ulcer caused by H. pylori is different from that for an ulcer caused by NSAIDs.

H. pylori is diagnosed through blood, breath, and tissue tests. Blood tests are most common. They detect antibodies to H. pylori bacteria. Blood is taken at the doctor’s office through a finger stick.

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Breath tests are mainly used after treatment to see if treatment worked, but they can be used in diagnosis, too. The test is called a urea breath test.

In the doctor’s office, the patient drinks a solution of urea that contains a special carbon atom. If H. pylori is present, it breaks down the urea, releasing the carbon. The blood carries the carbon to the lungs, where the patient exhales it. The breath test is 96 percent to 98 percent accurate.

Tissue tests are usually done using tissue removed with the endoscope. There are three types:

1. The rapid urease test detects the enzyme urease, which is produced by H. pylori.

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2. A histology test allows the doctor to find and examine the actual bacteria.

3. A culture test involves allowing H. pylori to grow in the tissue sample.