ROSH Gastrointestinal Practice Exam

What is the gold standard for diagnosing peptic ulcer disease?

1. Endoscopy

2. Helicobacter pylori testing

3. Upper GI series

4. Urea breath test

The correct answer is: Endoscopy

Endoscopy is considered the gold standard for diagnosing peptic ulcer disease because it allows direct visualization of the gastrointestinal mucosa. During an endoscopic procedure, a flexible tube with a camera, known as an endoscope, is inserted through the mouth and into the stomach and duodenum. This enables the physician to identify the presence of ulcers, assess their characteristics, and potentially perform biopsy or therapeutic interventions if necessary. While other methods, such as Helicobacter pylori testing and upper GI series, can provide valuable information regarding the condition, they do not offer the same direct visualization and diagnostic accuracy as endoscopy. Helicobacter pylori testing can confirm the presence of the bacteria associated with the majority of peptic ulcers, but it does not directly visualize the ulcer itself. An upper GI series can identify the presence of ulcers indirectly through imaging, but it does not provide the detailed information that endoscopy does. The urea breath test specifically assesses H. pylori infection but is not used to diagnose peptic ulcers directly. Thus, endoscopy remains the most definitive method for both diagnosis and management of peptic ulcer disease.