Can an Endoscopy Diagnose a Stomach Ulcer?

Endoscopy procedures allow doctors to directly visualize an ulcer and are an important part of the diagnostic process.

Endoscopies can help doctors differentiate ulcers from other conditions, such as stomach cancer. Your doctor will likely want to perform an endoscopy if you have minor or severe stomach ulcer symptoms or signs of internal bleeding.

Stomach ulcers can cause symptoms such as:

• abdominal pain, typically located in one spot between your breastbone and belly button
• feeling full a short while after you start a meal
• feeling uncomfortably full after finishing a meal
• nausea
• heartburn

While some ulcers may heal without treatment, most do not get better or go away on their own.

If you think you have symptoms of an ulcer, it’s a good idea to make an appointment with your doctor. It’s especially important to get medical attention if your symptoms are getting worse. Your doctor will likely order an endoscopy to help determine whether you have an ulcer.

Symptoms that an ulcer may be starting to bleed and may require prompt medical attention include:

• pale skin
• shortness of breath with activity
• fatigue
• lightheadedness
• worsening abdominal pain that doesn’t go away

A heavily bleeding ulcer is a medical emergency. Get medical attention right away if you have:

• blood in your stool
• bloody vomit that looks like coffee grinds
• symptoms of shock

1. You won’t be able to eat or drink for at least 8 hours before your procedure. Shortly before the procedure starts, you’ll typically be given a sedative through an IV to keep you relaxed. Rarely, the procedure may be performed with general anesthesia or no sedation.
2. During an endoscopy procedure, your doctor will put a long, flexible tube called an endoscope down your throat and into your stomach. It’s performed by a specialist called a gastroenterologist.
3. During the procedure, your doctor will use the camera on the endoscope to look for ulcers in your stomach. The end of the endoscope has a light, a camera, and special tools. A live image of your stomach will be visible to your doctor.
4. If your doctor finds a stomach ulcer, a special tool at the end of the endoscope will allow them to take a small tissue sample. This sample is called a gastric biopsy. It will be tested in a laboratory for stomach cancer and a type of bacterial infection called Heliobacter pylori, which is a common cause of stomach ulcers.
5. If your doctor notices bleeding from the ulcer, it might be treated during this procedure.
6. You typically won’t feel any pain during the procedure, but your throat might be a little sore afterward.
7. You can usually leave the hospital on the same day. The procedure itself usually only takes about 5 to 10 minutes.

Endoscopy to treat a bleeding ulcer

Bleeding is the most common complication of stomach ulcers. Endoscopy is the primary treatment for bleeding ulcers.

Different methods can be used during an endoscopy to treat bleeding ulcers. Some of these methods include:

• Injection therapy: Injecting the ulcer with epinephrine can help stop bleeding. If bleeding reoccurs, it usually returns in the first 72 hours.
• Thermocoagulation therapy: Thermocoagulation therapy involves heating the ulcer to stop the bleeding.
• Hemoclips: Hemoclips are small clips that can stop bleeding in the gastrointestinal tract. They can be effective as a primary therapy but tend to dislodge after 48 to 72 hours.
• Suturing: In a small study, researchers found that sutures were an effective method to stop bleeding. More research is needed to know if suturing is more effective than other treatments.

After endoscopy treatments, you may have a follow-up procedure 4 to 6 weeks later to see if the ulcer has completely healed.

Endoscopy is not the only method to treat or manage stomach ulcers. Treatments vary based on the underlying cause and can include:

• Antibiotics: Heliobacter pylori bacterium is present in about 85% of people with stomach ulcers. A 2-week course of antibiotics is usually prescribed for this type of infection. Additionally, proton pump inhibitors are often used for 4 to 8 weeks to reduce stomach acid.
• Stopping NSAIDs: About 90% of stomach ulcers are linked to nonsteroidal anti-inflammatory drugs (NSAIDs) use. Your doctor may suggest stopping NSAIDs if this is the cause of your ulcer.
• H2-receptor antagonists: These medications work to inhibit the production of stomach acid.
• Antacids: These common, over-the-counter medications can help neutralize stomach acids.
• Probiotics: Probiotics may help fight Heliobacter pylori infections, a leading cause of stomach ulcers.
• Bismuth supplements: Bismuth therapy can be effective in suppressing the Heliobacter pylori bacterium.
• Surgery: In rare cases, surgery may be necessary to remove an ulcer.

Endoscopy is a procedure that involves having a long thin tube with a camera on the end inserted down your throat and into your stomach. It allows doctors to clearly see the inside of your stomach and to determine whether you have an ulcer.

Endoscopy also allows doctors to take a small tissue sample of an ulcer to test it for Heliobacter pylori infection or cancer. If your ulcer is bleeding, your doctor can stop the bleeding using heat, injections, or other techniques during an endoscopy procedure.