You may not need a test at all, depending on how "classic" your symptoms are for peptic ulcer, your risk of other illnesses, and your other health issues. There is nothing wrong with "empiric" treatment (treating without testing) PROVIDING that there is relatively little chance that a delayed diagnosis will be harmful.

Bobert, I have no idea whether your particular symptoms are "classic" (straightforwardly suggesting peptic ulcer and nothing else) or not, nor do I have any idea what your risk is of other illnesses. If my daughter (who has no significant risk factors for other illnesses) had classic ulcer symptoms, I would treat her without testing. If she were well in 14 days, that would be the end of it.

If my father, who has a high risk of esophageal cancer, had exactly the same symptoms, I would insist someone look down his esophagus with a scope.

The point is this: if the doctor thinks you have peptic ulcer disease but suggests a test to be sure, ask, "What's the risk if you just treat me and see if it works?" and "If it were your brother, would you order the test or would you treat him first and see how it worked?" and "What's the least expensive way to get this test done?" It may be, for example, that all you need is a breath test for H.Pylori infection rather than a CT scan and upper endoscopy. And maybe not. Even if you do need expensive testing, shop around. There are BIG price differences from facility to facility. The prices are not secret; most people just don't bother to ask.

There is no harm in asking questions. If you don't ask, the doctor may ASSUME you want an immediate definitive diagnosis no matter what the cost. (That, by the way, is the approach most of my patients take - but most of them have the taxpayers footing the bill).

Hope you find this useful.

Kent