Your doctor may treat you on the assumption of a diagnosis, but may well arrange either a barium meal X-Ray or a visual inspection using a fiber-optic tube passed down the throat (upper gastrointestinal endoscopy). The endoscopy is preferred by the experts as they can see the lining of the stomach and duodenum and take biopsies which allow them to rule out more serious conditions as well as looking for the presence of Helicobacter pylori.

Tests are carried out to see if there is infection with H. pylori, to diagnose gastric or duodenal ulcers, and to rule out other conditions such as stomach cancer.

H. pylori tests - someone with suspected peptic ulcer is likely to be tested for H. pylori. This is done with either a breath or blood test. For the breath test, you are given a harmless substance to swallow. The substance is broken down if H. pylori is present, to produce a gas that is detected in the breath. This test is also used to check whether treatment has eradicated H. pylori.

Barium swallow - this involves swallowing a drink containing barium, which shows up white on X-rays. The barium coats the lining of the stomach and duodenum, and X-rays are taken to show an outline. These may show an ulcer.

Gastroscopy - a tube (endoscope) containing a fiber-optic cable is passed through the mouth and into the stomach. The doctor can see the lining of the stomach through the tube, and can take a sample of the stomach lining with an instrument that is passed down through the tube. This sample is tested for H. pylori and examined under a microscope (biopsy) to check whether cancer is present.