Updated 20 December 2017

Diagnosing peptic ulcers

A diagnosis can be made once your medical history along with you symptoms and any over-the-counter medications you are using are reviewed by your doctor.


Your doctor may suspect a peptic ulcer when he or she notes your symptoms, but because the symptoms of the different ulcers are very alike, several tests may be ordered to make a specific diagnosis.

Presence of H. pylori

For diagnosing a stomach ulcer, your doctor may request an upper gastrointestinal endoscopy or gastroscopy.

Note that if your doctor has requested a gastroscopy, you will need to fast for 12 hours before the procedure.

During a gastroscopy you are sedated, and a slim, flexible lighted tube is inserted through your mouth to examine the stomach, oesophagus and duodenum. The doctor can also take a biopsy of the lining of the stomach tissue to test for H. pylori infection during the procedure. Biopsies, especially of stomach or gastric ulcers that may be cancerous, can be examined under a microscope to determine if cancer is present.

The doctor may also order a blood test to check for anaemia (which indicates internal bleeding), an analysis of a stool sample to check for blood (indicating a bleeding ulcer) or other blood tests to check for the presence of H. pylori bacteria.

A breath test can also diagnose H. pylori. Urine and stools test have also recently been developed.

Because the severity of the symptoms varies so widely, symptoms alone are usually not a good indication of the presence or severity of an ulcer. Ulcers often come and go unnoticed by sufferers; they might only become aware of the condition when a serious complication such as bleeding or perforation occurs.

Read more:

What are peptic ulcers?

The causes of peptic ulcers

The complications of peptic ulcers

Revised and reviewed by Dr John P Wright MBChB, MRCP (UK), PhD. Gastroenterologist in private practice, Cape Town. February 2015

Previously reviewed by Prof Jan van Zyl, Department of Gastroenterology, University of the Free State, July 2011