Diagnosis of Peptic Ulcer

Even though there are many causes for peptic ulcer, the major one is infection of Helicobacter pylori. It was in 1983, the role of this bacterium was discovered and that administering antibiotics against H. pylori cures peptic ulcer. It took many years for medical practitioners to accept the fact and a lot of researches have conducted to substantiate this. Till then, it was believed that stress, alcohol and spicy foods were causative to this illness. Bland diet and bed rest were the treatments given to patients so far.

Tests for diagnosing the disease include upper gastro intestinal (GI) series or endoscopy. By taking a GI series, doctor will be able to see an X-ray of oesophagus, stomach and duodenum. In this method, the patient will be asked to drink barium containing liquid and the path will be tracked or mapped using X-ray. In endoscopy, a thin tube with camera and light at one end (endoscope) will be passed into digestive track through mouth. By this, the doctor will be able to get a detailed picture of inner epithelial lining and mucous membrane. Using endoscope, doctor can take photos and also a small epithelial tissue part for microscopic analysis. The process is known as biopsy. Doctor can also inject medicine into the lining if it is found bleeding. This can enhance clotting or to heal the sore. Using heat probe that cauterizes ulcer can also be applied by doctor with the help of endoscope.

Testing Helicobacter Pylori

Testing the presence of H. pylori is done in ulcer patients now. The results will rule out the chance of ulcers caused by NSAID group drugs and other factors. The presence of this bacterium can be done by testing blood, tissue, breath and stool samples. Out of this, blood tests are done commonly and also detect the presence of antibodies against Helicobacter pylori. Blood is usually taken through finger stick. Urea breath tests are effective in diagnosing the presence of this bacteria.

The presence of Helicobacter pylori stool antigen (HpSA) in stool sample is considered as a confirmatory test for peptic ulcer.

Tissue samples taken from gastric epithelium can be used to test the presence of Helicobacter pylori. Three major tests with tissue samples are

Rapid urease test to assay urease enzyme production of H.pylori
Histology test to identify bacterial strain
Culture test to grow H.pylori from tissue sample

Posted By : Jose Jobin

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