Describing your symptoms may lead your doctor to suspect that you have a peptic ulcer, but it will not likely help determine the type, because the symptoms of stomach and duodenal ulcers are so similar. To make a specific diagnosis, your doctor may administer several tests.
One such test is a barium swallow or upper GI series of X-rays that allow your doctor to identify and locate the ulcer and determine its type and severity. The test requires you to drink a "barium milkshake," which has a liquid that will show up on an X-ray. You may be asked to eat only bland, easily digestible foods for two or three days before the test. After drinking the chalky liquid, you lie down on a tilting examining table, which evenly distributes the barium around your upper digestive tract and allows the X-ray to capture images at different angles.
If you do not respond to treatment or if you develop new symptoms, your doctor may perform a gastroscopy, or endoscopic exam, in which a flexible fiber-optic tube is inserted down your throat to give the doctor a direct view of the inside of your esophagus, stomach, and duodenum. This allows the doctor to determine the presence and cause of bleeding and test for any bacterial infection. During this exam, your doctor may also conduct a biopsy to check for cancer.
What Are the Treatments for an Ulcer?
Medications are usually used to treat mild-to-moderate ulcers. If the cause is bacterial, antibiotics can cure the ulcer. For recurrent, severe cases that do not respond to medication, surgery may be necessary.
Although alternative therapies have been shown to aid in the relief of symptoms, they should be used only as supplements to conventional treatment.
You should not treat an ulcer on your own without first seeing your doctor. Over-the-counter antacids and acid blockers may relieve some or all of the pain, but the relief is always short-lived. With a doctor's help, you can find relief from the ulcer pain, as well as a lifelong cure from the disease. Proton-pump inhibitor drugs such as Prilosec are the most cost-effective treatment options for peptic ulcers.
The chief goals of treatment are reducing the amount of acid in the stomach, strengthening the protective linings that come in direct contact with gastric acids, and -- if your ulcer is caused by bacterial infection -- treating the H. pylori infection with medication. Your doctor will likely prescribe a combination of antibiotics, such as amoxicillin or tetracycline with metronidazole, along with Pepto-Bismol, proton-pump inhibitors, and/or histamine H2 blockers, all to be taken for 10-14 days.
If these treatments are unsuccessful, or if you have developed serious complications as a result of your ulcer, surgery may be necessary. If your ulcer is hemorrhaging, the surgeon will identify the source of the bleeding (usually a small artery at the base of the ulcer) and repair it. Perforated ulcers -- holes in the entire stomach or duodenal wall -- must be surgically closed. This is an emergency procedure.
In some cases, a surgery to decrease stomach acid secretion may be necessary. However, peptic ulcer surgery is done only in emergency situations, because there are many potential complications associated with the procedure, including ulcer recurrence, liver complications, and ''dumping syndrome,'' which causes chronic abdominal pain, diarrhea, vomiting, and/or sweating after eating.