Stomach Ulcer Diagnosis

Stomach ulcers (also known as peptic ulcers) are diagnosed by qualified medical professionals using sophisticated equipment for testing.

Even if your stomach ulcer symptoms match the common symptoms, only by diagnostic testing can you get a stomach ulcer diagnosis. There are two common tests used to diagnosis peptic ulcers: a barium chalk test and an endoscopy.

Below, you will find details on each of these two tests and the pros and cons of each approach.

Barium Chalk Test

The Barium Chalk test is a common method for stomach ulcer diagnosis. It is also the least invasive method, as it is relatively low-cost (much lower than an endoscopy) and is completely non-invasive.

This test involves having the patient drink a barium chalk solution (bitter, chalky, white liquid) which then coats the lining of the gastrointestinal tract. An X-ray of the chest and abdomen is taken, and the barium chalk solution essentially highlights the areas of the gastrointestinal tract. An ulcer, which is an erosion of the stomach or intestinal lining, should cause an irregularity in this otherwise smooth image.

The only downside from this type of testing is it is not 100% accurate in its peptic ulcer diagnosis. For example, a few ulcers out of every 100 cases are cancerous, and a barium chalk test is unable to report this.


The most reliable yet expensive and invasive way to get a stomach ulcer diagnosis is via endoscopy. An endoscopy is the procedure during which a gastroenterologist navigates a tube down the patient’s esophagus and into the stomach. The end of the tube contains a camera, which the doctor then uses to capture images of the stomach.

By examining the stomach and duodenum directly, the doctor can get a direct image of the ulcer. Cancerous ulcers tend to have an irregular shape and can be off color, something not seen on an X-ray. Not only that, but he (or she) can also take a tissue sample. This sample can be tested for malignancy and for H pylori, the latter of which is the bacteria which causes most ulcers and stomach ulcer symptoms.

The major downside to this test is that it is invasive and expensive. Since a tube is inserted down the patient’s esophagus (into the throat and down the “food hole”), sedation is typically required for this procedure. Because of this and the time it takes the doctor to do this test, it can be quite expensive as well. Many patients also report a sore throat over the next few days after having this done.

Breath Testing

Once you have a peptic ulcer diagnosis, the next important step is to get an H pylori test to see if you have a bacterial infection. H pylori is the most common cause of ulcers and can be easily tested for via an urea breath test.

A urea breath test is quite simple: drink a solution containing urea and then breathe into a meter. H pylori gives off ammonia gas when exposed to urea, which can then be detected by a gas meter.

Note that many doctors will opt for an urea breath test first and skip over endoscopy or barium chalk testing altogether in adults ages 18-40. If the test is positive, they will then recommend treating the H pylori. This is known as the test and treat model, and has been shown to have similar success rates to endoscopy-first procedures. Naturally, it is much cheaper for the patient to skip over the endoscopy.

This is typically only done in younger adults. Stomach cancer and bleeding ulcers are much more common in older adults, hence the difference in treatment recommendations based on age. Your doctor may also recommend one approach over the other based on your medical history or mutual preference.

Related posts:

  1. H Pylori Test
  2. Signs of a Stomach Ulcer
  3. Duodenal Ulcer
  4. Urea Breath Test
  5. Gastric Ulcer Symptoms