Peptic Ulcer

A peptic ulcer is a sore in the lining of the stomach or duodenum. Most ulcers are linked to Helicobacter pylori (H. pylori) infection or NSAID use (aspirin, ibuprofen, naproxen). Ulcers can cause burning upper-abdominal pain, nausea, or bloating—and sometimes no symptoms until there is bleeding. A proactive testing plan focuses on noninvasive H. pylori tests and bloodwork that checks for hidden blood loss or complications.

Start with H. pylori stool antigen or urea breath testing (UBT) for suspected ulcer disease. Add a CBC and iron studies to look for anemia, a CMP for hydration and organ function, and fecal occult blood/FIT if bleeding is a concern. In some cases, CRP can provide inflammation context, and amylase/lipase may be checked if severe pain raises concern for complications. Labs guide next steps, but they do not replace a clinician’s exam or upper endoscopy (EGD) when visualization or biopsy is needed.

Signs, Symptoms & Related Situations

  • Typical: burning or gnawing pain in the upper abdomen, often between meals or at night; nausea, early fullness, bloating, belching

  • Possible bleeding: black/tarry stools, vomiting “coffee-grounds,” fatigue from anemia

  • Risk clues: frequent NSAID/aspirin use, prior H. pylori, smoking, heavy alcohol use, family history

  • Alarm features: unintentional weight loss, persistent vomiting, trouble swallowing, iron-deficiency anemia, age ≥60 with new symptoms

  • When to seek urgent care: vomiting blood, black stools with dizziness or fainting, sudden severe abdominal pain (possible perforation)
    All symptoms should be evaluated by a qualified clinician.

Why These Tests Matter

What testing can do

  • Detect active H. pylori infection (stool antigen or UBT)

  • Identify anemia and biochemical changes that suggest bleeding or dehydration (CBC, iron panel, CMP)

  • Provide screening evidence of bleeding (fecal occult blood/FIT) and a baseline to monitor trends

What testing cannot do

  • Replace endoscopy when ulcers, bleeding, or alarm features are suspected

  • Determine the exact cause of pain without clinical evaluation

  • Serve as population screening when symptoms are absent—use tests matched to the question

What These Tests Measure (at a glance)

  • H. pylori Stool Antigen (preferred noninvasive test): detects active infection. Caveat: stop PPIs for ~2 weeks and antibiotics/bismuth for ~4 weeks before testing if advised by your clinician; follow prep instructions.

  • Urea Breath Test (UBT): detects active H. pylori by labeled CO2 in breath after a urea drink. Caveat: same medication holds/prep apply; not for very young children or those unable to cooperate.

  • H. pylori Serology (IgG): shows past exposure and is not recommended to confirm active infection or test-of-cure.

  • CBC (Complete Blood Count): checks for anemia from chronic or acute bleeding. Caveat: interpret with iron studies.

  • Iron Studies (Ferritin, Iron, TIBC/TSAT): iron-deficiency pattern supports chronic blood loss. Caveat: ferritin rises with inflammation.

  • CMP (Electrolytes, Kidney/Liver): dehydration and organ context; BUN may rise with upper-GI bleeding.

  • Fecal Occult Blood or FIT (stool): detects hidden blood in stool. Caveat: positive tests prompt endoscopic evaluation—do not repeat stool testing instead.

  • CRP (optional): nonspecific inflammation marker for clinical context.

  • Amylase/Lipase (when severe pain): rules out pancreatic involvement or complications.

How the Testing Process Works

  1. Start with H. pylori testing: order stool antigen or UBT based on availability and clinician guidance.

  2. Add context labs: CBCiron studies, and CMP to assess bleeding and overall status; consider FIT/occult bloodif stool blood is suspected.

  3. Follow preparation: hold PPIs/antibiotics/bismuth as instructed for accurate H. pylori results.

  4. Access results securely: most reports post within a few days.

  5. Plan next steps: your clinician may recommend endoscopy to confirm ulcers, treat bleeding, or take biopsies, and to plan follow-up testing as needed.

Interpreting Results (General Guidance)

  • Positive H. pylori stool antigen or UBT: supports active infection in the right clinical setting; discuss next steps with your clinician.

  • Negative H. pylori with persistent symptoms/alarm features: endoscopy may still be indicated.

  • Low hemoglobin/iron indices: support occult or overt bleeding; correlate with FIT/occult blood and symptoms.

  • Normal labs do not rule out ulcer disease—clinical evaluation and, when appropriate, endoscopy determine diagnosis.
    Always interpret results with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • First-line for suspected ulcer: H. pylori stool antigen or UBT

  • Bleeding or chronic symptoms: CBC + iron studies + CMP, plus FIT/occult blood if indicated

  • Persistent or complicated cases: add CRP and amylase/lipase per clinician judgment; prioritize endoscopy for visualization/biopsy

  • Post-therapy test-of-cure (H. pylori): stool antigen or UBT after appropriate medication hold and clinician-directed timing

FAQs

Is a blood test for H. pylori enough?
No. Serology shows past exposure and is not reliable for active infection; use stool antigen or UBT.

Do I need to stop medicines before H. pylori testing?
Often yes. PPIs, antibiotics, and bismuth can affect accuracy; follow the prep on your order or your clinician’s advice.

Can labs prove I have an ulcer?
No. Labs suggest infection or bleeding; endoscopy confirms ulcers and allows biopsy/treatment.

What if my H. pylori test is negative but I still have symptoms?
Your clinician may evaluate for NSAID-related ulcers, reflux, or other causes, and may recommend endoscopy.

When should I repeat H. pylori testing?
For test-of-cure after treatment, using stool antigen or UBT at the clinician-directed interval and medication holds.

Internal Links & Cross-References

  • Digestive System Tests Hub

  • H. pylori

  • Digestive Health

  • Celiac Disease

  • Inflammatory Bowel Disease (IBD)

  • Colon (Intestine)

  • Key Lab Tests: H. pylori Stool Antigen • Urea Breath Test • CBC • Iron Panel (Ferritin, Iron, TIBC/TSAT) • CMP • FIT/Occult Blood • CRP • Amylase • Lipase

References

  1. American College of Gastroenterology. Clinical Guideline on the Diagnosis and Management of H. pylori Infection.

  2. American College of Gastroenterology. Guideline for the Management of Patients With Dyspepsia and Peptic Ulcer Disease.

  3. American Gastroenterological Association. Best Practice Advice on H. pylori Testing and Test-of-Cure.

  4. European Helicobacter and Microbiota Study Group. H. pylori Management Consensus.

  5. American Society for Gastrointestinal Endoscopy. Role of Endoscopy in Upper GI Bleeding and Peptic Ulcer Disease.

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Peptic Ulcer—Testing and Diagnosis.

Available Tests & Panels

Your peptic ulcer test menu is pre-populated in the Ulta Lab Tests system. Start with H. pylori stool antigen or urea breath testing, add CBC/iron studies/CMP for bleeding and hydration context, and use FIT/occult blood when indicated. Follow preparation instructions for accurate results and review all findings with your clinician.

  • Page
  • 1
  • of
  • 1
  • Total Rows
  • 6
Name Matches

The Helicobacter pylori Urea Breath Test detects H. pylori infection, a common cause of ulcers and gastritis. After drinking a urea solution, breath samples are analyzed for carbon dioxide changes caused by the bacteria. A positive result indicates active infection, while a negative shows no evidence of H. pylori. Doctors use this noninvasive test to diagnose infection, confirm eradication after treatment, and monitor gastrointestinal health.

Varied
Phlebotomist
Also Known As: H Pylori Breath Test

The Helicobacter pylori Antigen Stool Test detects H. pylori proteins in stool to diagnose active infection. H. pylori is a common cause of gastritis, ulcers, and increased stomach cancer risk. Doctors order this test for patients with abdominal pain, nausea, bloating, or indigestion. Noninvasive and accurate, results confirm active infection and are also used to monitor treatment effectiveness and eradication of H. pylori bacteria.

Stool
Stool Collection
Also Known As: H Pylori Stool Test

The Fecal Globin by Immunochemistry Test detects hidden (occult) blood in stool using antibodies that identify human globin protein. This test helps screen for colorectal cancer, polyps, ulcers, and gastrointestinal bleeding. Doctors order it when patients have anemia, abdominal pain, or changes in bowel habits. Results provide early detection of digestive tract bleeding, guiding further evaluation with colonoscopy or other diagnostic procedures.

Varied
Phlebotomist
Also Known As: Fecal Immunochemical Test, Fecal Occult Blood Test, Stool Occult Blood Test, FIT Test, FOBT

The Hemoglobin Test measures the amount of hemoglobin in blood, the protein that carries oxygen to tissues. Low hemoglobin may indicate anemia, blood loss, or nutritional deficiencies, while high levels may suggest dehydration, lung disease, or bone marrow disorders. Doctors order this test to evaluate fatigue, weakness, or shortness of breath. Results provide key insight into oxygen transport, red blood cell health, and overall hematologic function.

Blood
Blood Draw
Also Known As: Hgb Test

Most Popular

The Gastrin Test measures gastrin hormone levels in blood, which regulate stomach acid production. Elevated levels may indicate Zollinger-Ellison syndrome, gastrinoma, pernicious anemia, or chronic atrophic gastritis. Doctors order this test for patients with recurrent ulcers, abdominal pain, or unexplained diarrhea. Results help evaluate abnormal acid production, detect tumors, and guide treatment for gastrointestinal and metabolic conditions.

Blood
Blood Draw
Also Known As: Gastrinomas Test

Blood
Blood Draw

Physicians diagnose 4.6 million people in the United States with peptic ulcer disease every single year. These sores cause abdominal pain, bloating, nausea, vomiting, and more. So, if you've been experiencing these symptoms, you're not alone.

However, if you haven't gotten a diagnosis for peptic ulcer disease yet, you may need a peptic ulcer test. Peptic ulcer testing can help you get a definitive answer as to whether or not you're suffering from the condition.

And, if your test comes back positive, you can get the medical attention and care that you need to prevent further complications.

To learn more about peptic ulcers and the benefits of a peptic ulcer test, keep reading. We have everything you need to know in this peptic ulcer test guide.

What Is a Peptic Ulcer?

Peptic ulcers are open sores that develop on the inside of the stomach. Specifically, they form on the inner lining of the stomach wall. Some peptic ulcerations even develop at the start of the small intestine.

Ulcerations that form in the stomach are called gastric ulcers. On the other hand, duodenal ulcers are those that form in the small intestine.

What Are the Risk Factors for a Peptic Ulcer?

The most common risk factor in patients with peptic ulcers is NSAID use. Patients who develop peptic ulcers tend to take more NSAIDs than patients who do not. However, this isn't the only risk factor associated with the condition.

Another common risk factor is alcohol consumption. If you drink alcohol regularly, the alcohol can irritate and erode the lining of your stomach. Thus, your body can develop ulcerations. 

Over time, erosion from alcohol can cause an increase in the amount of stomach acid that your body is producing, too. So, you may have more extreme symptoms such as burning and vomiting.

A lesser-known contributor to the development of peptic ulcers is smoking. In patients who have H. pylori infections, smoking can increase the risk for peptic ulcers.

Lastly, we'll touch on spicy foods and stress once again. These two things do not cause peptic ulcers. However, they are considered risk factors for the condition since they can exacerbate already-existing issues in the inner lining of the stomach.

What Causes Peptic Ulcers?

There are multiple causes of peptic ulcers.

The most common cause is an H. pylori infection. H. pylori, or Helicobacter pylori, is a kind of bacteria that can wreak havoc on the digestive system. Unfortunately, most people with H. pylori infections don't even realize that they have an infection because they do not develop symptoms.

Another common cause of developing peptic ulcers is long-term NSAID use. NSAIDs are non-steroidal anti-inflammatory drugs. This includes things like ibuprofen (Advil), Motrin, and naproxen sodium (Aleve).

Taking too many of these kinds of medications can weaken the inner lining of your stomach. Therefore, ulcerations can form as the stomach lining breaks down.

Some people believe that stress and spicy foods can cause ulcers. However, this isn't supported by gastroenteric research. Rather, these kinds of factors make already-existing ulcers worse.

So, you should still avoid these if you're experiencing symptoms of a peptic ulcer or if you have an official diagnosis of peptic ulcer disease.

What Are the Signs and Symptoms of a Peptic Ulcer?

Since peptic ulcers affect your gastric system, patients with them often feel symptoms associated with their abdomen. However, it's important to note that many patients with gastric ulcers don't feel any symptoms. Feelings of pain and bloating may come slowly over time.

Here are some of the most commonly reported symptoms in patients with peptic ulcers:

  • Burning pain in the abdomen, especially in the left upper quadrant where the stomach is located
  • A persistent feeling of fullness in the stomach despite not eating recently
  • Bloating in the abdomen
  • Repeated belching
  • Intolerance to foods that are high in fat
  • A burning sensation in the heart
  • Persistent nausea

The most common symptom is burning abdominal pain. However, this can become better after eating. If you aren't eating for long periods of time, the ulcerations in your stomach can become exposed to the acid. Thus, the pain worsens.

This also explains why patients find that the stomach pain gets worse in between meals and at night.

Some patients find that they can relieve their pain by eating foods that block the acid in the stomach. Alternatively, you can take a medication that reduces stomach acid.

What Happens If Peptic Ulcers Go Untreated?

Patients that have advanced peptic ulcers have even worse symptoms. And, they can develop secondary conditions from the damage that the ulcerations are causing.

Here are the severe signs and symptoms of peptic ulcers:

  • Persistent vomiting
  • Vomiting blood which may appear red or black
  • Producing bloody stools with may appear dark and/or tarry
  • Trouble breathing
  • Lightheadedness
  • Unintentional weight loss
  • Changes in appetite

If you're experiencing these more serious symptoms, you should see a physician as soon as possible. Without treatment, your condition will only worsen.

In fact, several complications can come with peptic ulcers. Here are some of the most common complications that can happen in patients with peptic ulcers:

  • Internal bleeding, which can lead to anemia and even fatal blood loss
  • A perforation in the stomach wall, which can put the patient at an increased risk for infection in the abdominal cavity
  • An obstruction in the digestive system can make it impossible to keep food down, leading to vomiting and weight loss
  • The development of gastric cancer

If you think you're experiencing blood loss, you need to test your iron levels.

All in all, you need to make sure that you see a physician as soon as possible if you've started developing symptoms. The sooner you can start treatment, the less damage that these ulcerations can do.

What Lab Tests Diagnose Peptic Ulcers?

To determine whether or not you have peptic ulcers, your physician may run peptic ulcer tests. More specifically, they'll be looking for H. pylori. They can detect whether or not H. pylori bacteria are present in your system.

Although physicians can perform this test through blood, stool, or breath samples, breath samples are the most accurate. 

To do a breath test, you must first eat something that contains radioactive carbon. If you have H. pylori in your system, the bacteria will break down the radioactive carbon into carbon dioxide. So, when you breathe into a bag later, elevated levels of carbon dioxide will show up in your sample.

For blood and stool tests, your physician will simply take the sample they need and examine the sample under a microscope to check for the bacteria. 

If these tests come back positive, your physician will create a treatment plan for your condition. However, if they come back negative, your physician may begin testing for other conditions that produce similar symptoms.

Are There Diagnostic Tests to Diagnose Peptic Ulcers?

There are two diagnostic tests that your physician may consider running instead of or in congruence with the aforementioned lab tests:

  1. An endoscopy
  2. An upper abdominal series

During an endoscopy, a physician uses a scope to look at your upper digestive system. He/She will use a hollow tube with a lens to look down your throat and into your stomach and small intestine. With this device, he/she can check for any ulcerations.

If the physician does see an ulcer, they will likely take a biopsy of the area. With this biopsy, a laboratory technician can determine whether or not you have H. pylori bacteria in your system.

Physicians tend to opt for endoscopies in older patients, display signs of bleeding, or have had recent weight loss or loss of appetite. Usually, these patients will need a follow-up endoscopy to determine whether or not their treatment was successful in healing the ulcerations.

An upper abdominal series is less invasive than an endoscopy, but it can still give your physician some useful information about how your gastrointestinal system works. An upper abdominal series, also known as a barium swallow, is a series of x-rays that look at your esophagus, stomach, and small intestine.

During the study, you'll swallow a white liquid that contains barium. This liquid coats the entire digestive system, making it easier for your physician to see any ulcerations that you may have in your stomach or small intestine. 

An upper abdominal series is preferred for patients who are less emergent.

Getting a Peptic Ulcer Test

If you're starting to show signs and symptoms of a peptic ulcer, you need to get a peptic ulcer test. This can help you determine whether or not you need to start making some changes.

Without the test, your condition could go untreated. Then, you could be looking at complications like infections and perforations.

So, what are you waiting for? At Ulta Lab Tests, we have secure and confidential results and you don't need any insurance or referral. All you need to do is order your peptic ulcer test, visit a local testing facility, and then wait 24 to 48 hours for your results.

It's better to be safe than sorry. So, order your test today.