Peptic Ulcer (cont.)
What are symptoms of an ulcer?
Symptoms of ulcer disease are variable. Many ulcer patients
experience
minimal indigestion or no discomfort at all. Some report upper
abdominal
burning or hunger pain one to three hours after meals and in
the middle of
the night. These pain symptoms are often promptly relieved by
food or
antacids. The pain of ulcer disease correlates poorly with the
presence or
severity of active ulceration. Some patients have persistent
pain even
after an ulcer is completely healed by medication. Others
experience no
pain at all, even though ulcers return. Ulcers often come and go
spontaneously without the individual ever knowing, unless a
serious
complication (like bleeding or perforation) occurs.
How is an ulcer diagnosed?
The diagnosis of an ulcer is made by either a barium upper GI
x-ray or
an upper endoscopy (EGD-esophagogastroduodenoscopy) The barium
upper GI
x-ray is easy to perform and involves no risk or discomfort.
Barium is a
chalky substance administered orally. Barium is visible on x-
ray, and
outlines the stomach on x-ray film. However, barium x-rays are
less
accurate and may not detect ulcers up to 20% of the time.
An upper endoscopy is more accurate, but involves sedation of
the
patient and the insertion of a flexible tube through the mouth
to inspect
the stomach, esophagus, and duodenum. Upper endoscopy has the
added
advantage of having the capability of removing small tissue
samples
(biopsies) to test for H. pylori infection. Biopsies can also
be examined
under a microscope to exclude cancer. While virtually all
duodenal ulcers
are benign, gastric ulcers can occasionally be cancerous.
Therefore,
biopsies are often performed on gastric ulcers to exclude
cancer.
Next: What are ulcer complications? »
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