What investigations might I have?

Many doctors, when they suspect an ulcer, will test for the presence of the bacterium H. pylori, usually by a simple breath test or blood test. At this stage if this is positive, patients are likely to be prescribed an antibiotic-based course of treatment without further investigation. However, if symptoms are not relieved or if they return after the treatment is stopped, an investigation may be arranged.

Doctors often diagnose reflux disease and prescribe a course of treatment after hearing the patient’s symptoms, usually without needing any further investigation. However, if symptoms recur or are less clearly defined, an investigation may be arranged.

The usual investigations are a barium meal or endoscopy.

Your doctor will tell you not to take your acid-suppressing medication for at least two weeks before your investigation. This helps making an accurate diagnosis easier. A barium meal is a routine X-ray method to look at what’s going on inside your gullet, stomach and duodenum.

The barium meal is basically a cupful of barium-containing liquid, which you swallow. This helps show up any particular problems you may have on the X-ray. The investigation takes about 20 minutes.

You will be advised not to eat or drink for six hours before the barium meal. To obtain a clearer image, gas-producing tablets or drinks (or occasionally a muscle-relaxing injection) are used.

A procedure known as endoscopy uses a thin, flexible tube called a gastroscope to examine the gullet, stomach and duodenum in more detail. With an endoscopy it is also possible to take small pieces of tissue (biopsies) to be looked at under a microscope.

Your doctor will advise you not to eat or drink for six hours before the endoscopy. After a sedative injection or an anaesthetic throat spray, the gastroscope tube is passed over the tongue and down into the gullet, stomach and duodenum. A small amount of air is puffed into the gullet, stomach and duodenum so that these can be seen more clearly.

The examination takes about 10 minutes, during which time you will still be able to breathe normally.

You can usually go home within an hour of the examination.

If you have been sedated, you will need somebody to accompany you. You should not drive or go back to work until the next day.

If you receive a local anaesthetic of the throat, you shouldn’t eat or drink for about half an hour after the endoscopy.