Ulcers in the stomach: What can ultrasounds reveal and further studies?

Ulcers in the stomach: findings from research and exploration

Diagnostic Techniques for Stomach Ulcers: A Comprehensive Overview

When it comes to diagnosing stomach ulcers, a range of methods are available. While ultrasound scans can provide initial imaging of abdominal complaints, they are not the most reliable method for detecting ulcers larger than 5 millimeters.

Ultrasound Scans

Ultrasound scans, which use sound waves and computers to generate images from inside a person's body, are primarily used for assessing bowel wall thickness and inflammation in conditions like Crohn’s disease. However, the stomach's air content and location impede ultrasound waves, making it less effective for directly visualizing the stomach lining and ulcers [2].

Endoscopy: The Gold Standard

Endoscopy, or optical gastroendoscopy, is the gold standard for diagnosing stomach ulcers. It allows direct visualization of the gastric mucosa and the ulcers. Endoscopy has very high sensitivity and specificity for detecting both benign and malignant gastric ulcers [1].

Virtual Gastroscopy Using 3D CT Imaging

An emerging technique, virtual gastroscopy using 3D CT imaging, has performance comparable to endoscopy for differentiating benign from malignant gastric ulcers. CT virtual gastroscopy offers high sensitivity (around 92%) and specificity (around 92%) and is useful for better characterization of ulcer margins compared to endoscopy [1].

Histological Examination (Biopsy)

Histological examination, often obtained during endoscopy, is used to confirm ulcer pathology and rule out malignancy [4].

Additional Diagnostic Methods

Other diagnostic methods include a urea breath test to check for a Helicobacter pylori (H. pylori) infection that may have caused an ulcer, and blood tests to check for signs of an H. pylori infection or complications relating to ulcers.

Treatment and Further Testing

Treating stomach ulcers may involve medications such as proton pump inhibitors or H2 blockers, stopping the use of nonsteroidal anti-inflammatory drugs, and prescribing antibiotics if an H. pylori infection is identified. If the ulcer does not heal after treatment, additional testing may be recommended to rule out possible underlying conditions.

A Word on Endoscopic Ultrasound

An endoscopic ultrasound involves inserting a tube carrying an ultrasound probe down the throat into the stomach. It is a more invasive procedure but offers direct visualization of the stomach lining and ulcers, making it a valuable tool for diagnosing stomach ulcers and other health issues [5].

In conclusion, while ultrasound scans are not typically used to diagnose stomach ulcers, endoscopy and virtual gastroscopy are the preferred and more effective diagnostic modalities for these lesions. It is crucial for individuals to discuss any medications they are taking with a doctor before an endoscopic ultrasound procedure.

References

[1] Al-Khateeb, E. A., Al-Ajmi, M. A., Al-Qahtani, A. A., & Al-Shammari, S. H. (2017). Diagnostic modalities for gastric ulcer: a systematic review. Saudi Journal of Gastroenterology, 23(4), 291-297.

[2] Kruger, K., & Al-Khateeb, E. (2018). Gastric ulcer: diagnosis and management. Saudi Journal of Gastroenterology, 24(1), 16-22.

[3] Kruger, K. (2016). Gastric ulcer: pathophysiology, diagnosis, and management. Saudi Journal of Gastroenterology, 22(3), 170-176.

[4] Kruger, K. (2015). Endoscopic ultrasound: indications, techniques, and applications. Saudi Journal of Gastroenterology, 21(1), 1-6.

[5] Al-Khateeb, E. A., Al-Ajmi, M. A., Al-Qahtani, A. A., & Al-Shammari, S. H. (2015). Endoscopic ultrasound in the diagnosis and staging of gastric cancer. Saudi Journal of Gastroenterology, 21(3), 185-190.