Diagnosis relies on testing for the presence of Helicobacter pylori and taking a history with specific reference to nonsteroidal anti-inflammatory drug (NSAID) use and the presence of upper abdominal pain.
In patients aged ≥60 years presenting with dyspepsia, an endoscopy should be ordered. Endoscopy is diagnostic and may show an ulcer in the stomach or proximal duodenum. Patients aged under 60 years with dyspeptic symptoms should haveH pylori testing.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
[Evidence A]bc3f4328-6e34-405b-9d08-4a7c94722046guidelineAWhat are the effects of noninvasive H Pylori test and treat compared with early endoscopy in people with uninvestigated dyspepsia?[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
History
NSAID use, H pylori infection, smoking, increasing age, personal or family history of peptic ulcer disease, and an intensive care stay are key risk factors.
A common clinical feature is dyspepsia, a chronic or recurrent abdominal pain or discomfort centered in the upper abdomen.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
This symptom is commonly related to eating and is often nocturnal. However, the absence of epigastric pain does not rule out the diagnosis. In patients with duodenal ulcers, the abdominal pain may be severe and radiate through to the back as a result of penetration of the ulcer posteriorly into the pancreas.
Nausea and vomiting are uncommon; the former may be relieved by eating. Vomiting, if present, generally occurs after eating. Weight loss and anorexia may also be present.
A history of NSAID use and the relief of symptoms after the use of antacids may support the diagnosis. However, these are neither sensitive nor specific indicators. It should be noted that most people with dyspepsia do not have peptic ulcer disease.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
If diarrhea is also present, this may indicate Zollinger-Ellison syndrome. Rarely, nausea, vomiting, and early satiety indicate pyloric stenosis (a complication of peptic ulcer disease).
Importantly, peptic ulcers may cause no symptoms, especially in the elderly and those taking NSAIDs.
Physical exam
There may be some epigastric tenderness on palpation of the abdomen, but often there are no other signs on exam. The patient can generally show the site of pain with one finger ("pointing sign").
Atypical presentations of peptic ulcer disease also occur. Gastric and duodenal ulcers may cause occult blood loss and iron deficiency anemia. However, presentation may be sudden, with the signs of bleeding (hematemesis and/or melena and shock), or perforation with peritonitis.
Rarely, a succussion splash may be heard in patients with pyloric stenosis (caused by gastric outlet obstruction).
Endoscopy
Clinical guidelines that aid the evaluation of patients with dyspepsia should be applied when peptic ulcer disease is suspected.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
[47]ASGE Standards of Practice Committee, Banerjee S, Cash BD, Dominitz JA, et al. The role of endoscopy in the management of patients with peptic ulcer disease. Gastrointest Endosc. 2010 Apr;71(4):663-8.
http://www.asge.org/uploadedFiles/Publications_and_Products/Practice_Guidelines/The%20role%20of%20endoscopy%20in%20the%20management%20of%20patientswith%20peptic%20ulcer%20disease.pdf
http://www.ncbi.nlm.nih.gov/pubmed/20363407?tool=bestpractice.com
[48]National Institute for Health and Care Excellence. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. November 2019 [internet publication].
https://www.nice.org.uk/guidance/cg184
If the patient is aged ≥60 years with dyspeptic symptoms, prompt endoscopy is indicated.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
It is the definitive diagnostic test for peptic ulcer disease and upper gastrointestinal (GI) tract neoplasms. Debate continues as to whether patients aged under 60 years with alarm symptoms for dyspepsia (e.g., weight loss, anemia, vomiting, early satiety, or dysphagia) need endoscopy to exclude upper GI tract neoplasm; the need for endoscopy should be evaluated on a case-by-case basis.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
Endoscopy is widely available and is more sensitive and specific for peptic ulcer disease than barium radiography. Additionally, it enables biopsy (for diagnosing malignancy and for H pylori detection).
Barium radiography should be reserved for patients who are unable or unwilling to undergo endoscopy, and it is not routinely recommended.
H pylori testing
US guidance recommends noninvasive testing for H pylori(i.e., urea breath or stool antigen tests) in patients with dyspepsia who are aged under 60 years.[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
[49]Chey WD, Leontiadis GI, Howden CW, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017 Feb;112(2):212-39.
https://journals.lww.com/ajg/fulltext/2017/02000/ACG_Clinical_Guideline__Treatment_of_Helicobacter.12.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com
[50]Chey WD, Howden CW, Moss SF, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2024 Sep;119(9):1730-53.
https://journals.lww.com/ajg/fulltext/2024/09000/acg_clinical_guideline__treatment_of_helicobacter.13.aspx?context=featuredarticles&collectionid=5
[Evidence A]bc3f4328-6e34-405b-9d08-4a7c94722046guidelineAWhat are the effects of noninvasive H Pylori test and treat compared with early endoscopy in people with uninvestigated dyspepsia?[46]Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017 Jul;112(7):988-1013.
https://journals.lww.com/ajg/fulltext/2017/07000/ACG_and_CAG_Clinical_Guideline__Management_of.10.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28631728?tool=bestpractice.com
Do not request serologic (antibody) testing when detecting an active H pylori infection.[51]American Society for Clinical Pathology. Thirty five things physicians should question. Choosing Wisely, an initiative of the ABIM Foundation. 2016 [internet publication].
https://web.archive.org/web/20230316185857/https://www.choosingwisely.org/societies/american-society-for-clinical-pathology
Serology (antibody) testing gives less accurate results, and is unable to distinguish between active and historical infection.[49]Chey WD, Leontiadis GI, Howden CW, et al. ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017 Feb;112(2):212-39.
https://journals.lww.com/ajg/fulltext/2017/02000/ACG_Clinical_Guideline__Treatment_of_Helicobacter.12.aspx
http://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com
[52]Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022 Aug 8;gutjnl-2022-327745.
https://gut.bmj.com/content/71/9/1724.long
http://www.ncbi.nlm.nih.gov/pubmed/35944925?tool=bestpractice.com
[53]Best LM, Takwoingi Y, Siddique S, et al. Non-invasive diagnostic tests for Helicobacter pylori infection. Cochrane Database Syst Rev. 2018;(3):CD012080.
https://www.doi.org/10.1002/14651858.CD012080.pub2
http://www.ncbi.nlm.nih.gov/pubmed/29543326?tool=bestpractice.com
[54]McNulty C, Teare L, Owen R, et al. Test and treat for dyspepsia--but which test? BMJ. 2005 Jan 15;330(7483):105-6.
http://www.ncbi.nlm.nih.gov/pubmed/15649907?tool=bestpractice.com
Histology and biopsy urease testing (rapid urease test) are invasive, and are reserved for patients in whom endoscopy is indicated. Both tests can detect H pylori; however, histology can determine if the ulcer is neoplastic (very rarely) and/or if there is evidence of an NSAID being the likely cause.
Proton-pump inhibitors, bismuth, or other medications can interfere with the performance of diagnostic tests for H pylori. Switching to an H2 antagonist for 2 weeks prior to endoscopy may be an alternative, especially in patients without alarm features.
Other investigations
A CBC should be ordered if the patient seems clinically anemic or has evidence of GI bleeding.
If the patient presents with upper GI bleeding, endoscopy is usually carried out first-line; however, if endoscopy is not possible, computed tomography angiography (CTA) abdomen and pelvis or visceral angiography are alternatives that may be considered depending on the stability of the patient to undergo these procedures.[55]American College of Radiology. ACR appropriateness criteria: nonvariceal upper gastrointestinal bleeding. 2024 [internet publication].
https://acsearch.acr.org/docs/69413/Narrative
[56]Sengupta N, Kastenberg DM, Bruining DH, et al. The role of imaging for GI bleeding: ACG and SAR consensus recommendations. Radiology. 2024 Mar;310(3):e232298.
https://pubs.rsna.org/doi/10.1148/radiol.232298
http://www.ncbi.nlm.nih.gov/pubmed/38441091?tool=bestpractice.com
Zollinger-Ellison syndrome should be considered in patients with multiple or refractory ulcers, diarrhea, ulcers distal to the duodenum, or a family history of multiple endocrine neoplasia type 1. In these patients, a fasting serum gastrin level should be ordered to look for evidence of gastrin hypersecretion. The patient should stop taking proton-pump inhibitor (PPI) therapy prior to the test.