investigations

Last reviewed 03/2023

• a suspected gastric ulcer may be a malignancy and should always be biopsied. If the lesion is identified on a barium meal then biopsies must follow. A further endoscopy must occur after treatment to ensure healing. Most benign gastric ulcers occur on the lesser curve of the stomach or in the prepyloric region.
• duodenal ulceration is almost never the site of malignancy and therefore it usually not necessary to undertake biopsies. In this case, diagnosis can be be made on barium meal or endoscopy. A follow-up endoscopy to ensure healing after treatment if the patient has become asymptomatic is generally not required.
• gastrin levels if suspected Zollinger-Ellinson syndrome - numerous or difficult to treat ulcers
• acid-output studies are not often required
• tests for H.pylori are now considered to be very important