How to Diagnose Duodenal Ulcer

A duodenal ulcer is a well-defined break in the mucosa of the duodenum, usually less than 1 cm. These ulcers almost always occur in the first part of the duodenum and may penetrate the muscularis propria. Duodenal ulcers are found in up to 15 percent of the population and should be diagnosed promptly because the complications can be serious. The following steps will show how to diagnose duodenal ulcers.

Instructions

Difficulty: Challenging

1. Expect presenting symptoms of a duodenal ulcer to cover a wide range, from completely asymptomatic to a gastronintestinal hemorrhage. The most common symptoms are a sharp burning epigastric pain that may radiate to the back and inappropriate feelings of hunger. Belching and bloating are also experienced in 20 to 40 percent of cases.
2. Observe tenderness over the epigastrum during a physical examination. This is usually the only physical finding in cases without complications, although it is not characteristic for a duodenal ulcer.
3. Conduct non-specific laboratory studies to eliminate other diagnoses. A complete blood count, liver functioning tests and measurement of amylase and lipase levels are routinely run in cases involving upper abdominal pain.
4. Perform more specific non-invasive tests to detect Heliobacter pylori, a common cause of duodenal ulcers. A breath test for urea, a waste product of Heliobacter, may be done as a preliminary test. The presence of Heliobacter may then be confirmed with an enzyme-linked immunoassay for Heliobacter pylori antibodies.
5. Confirm a diagnosis of a duodenal ulcer with an endoscopy of the esophagus, stomach and duodenum. This procedure is invasive and may require sedation, but is the most sensitive test available.