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I have a suspected ulcer. I tried to go for an endoscopy but…

Customer Question
Hi, I have a...

Hi, I have a suspected ulcer. I tried to go for an endoscopy but had numerous panic attacks beforehand and was unable to complete it. The alternative now is a barium test. Which is more likely to possibly indicate a stomach uler, barium CT of barium xray?

Doctor's Assistant: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?

It's been suspected for a couple of months now. Dr prescribed 1st level treatment including PPI. However symptoms persisting, hence the scheduled endoscopy. Have been told that barium test is viable alternative to investigate. However I want to get as accurate as possible.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have persistent pain in my stomach, nausea sometimetimes and pain in my back. I am currently on PPI 2xday

Submitted: 4 months ago.Category: Medical
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Answered in 5 minutes by:
3/14/2018
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,717
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Customer reply replied 4 months ago
Hi, I have just paid via Paypal. To continue, I am try to decide how to pursue this further. Do I ask for a double barium CT scan? Would this be more accurate than a barium(double) xray? I am in the UK where the NHS will be looking at cost, however if a CT is preferable I would consider having this done privately. Also, I believe the urease breath test for h Pylori is very accurate...is this correct?
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Yes, a urease breath test is very accurate for detection of Helicobacter pylori which is one of the commonest cause of peptic ulcer. If this is positive, you may be prescribed antibiotics with PPI.

But if the urease breath test is negative, still there is a possibility of peptic ulcer as some ulcers are not caused by Helicobacter pylori. In that case you would need medical imaging.

CT scan does not have much role in peptic ulcer detection. So a barium meal series would be the option.

There is a new techniques in CT scanning. though cost can be a huge factor. This is called; Multidetector row CT (MDCT) scanning and three-dimensional (3D) imaging. This is called as virtual endoscopic imaging which is a 3 dimensional reconstruction of computer images, which may be helpful for detecting peptic ulcer.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 4 months ago
If they give the option of double barium xray versus double barium CT which would be preferable? I agree, CT on it's own will show nothing, however a double barium CT might?
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

Double contrast barium x-ray is still a better option.

A double contrast CT scan has low sensitivity and specificity of picking the gastric and duodenal ulcers (collectively called peptic ulcer).

Some centers are doing 3 dimension reconstruction of the CT scan; than the detection rate is very good and chance of missing is low.

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

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