Which is the best investigation for detecting gastric ulcer?

Dear Ask The Doctor: I am having trouble with pain under my right rig cage,ihave had a ultra sound to see if it was my gall bladder and given ulser meds with took some of my discomfort away but still have discomfort under my right rig cage. my doctor thinks its nerves and is not going to do anything else but has said ok to me going to see about a scope. the problem is i cant afford a scope and was wondering if a mri which is 375.00 in our area would show what was wrong in there, some have told me yes and others have said no? What do you think. I do not have pain from food

Dear Cheryl: Fiberoptic endoscopy of the upper GI tract is the investigation of choice when it comes to diagnosing patients with suspected gastric ulcer. However, endoscopic examination are more invasive and costly as compared to double-contrast barium studies.

I would suggest that you consult your doctor for double contrast barium examination which has been shown to have a sensitivity as high as 95% in the detection of a gastric pathology and is a useful alternative to endoscopy. The drawback is that a biopsy is not possible when there is a suspected lesion. CT and MRI have no part in the primary detection of gastric ulcer.