The syndrome differentiation of this disease is to identify cold, heat, excess and deficiency. In general, most of the new and acute cases have excess and heat, while most of the chronic cases have deficiency and cold. Clinically, it is classified as syndromes of disharmony of liver and stomach, deficiency of spleen and stomach yang, deficiency of stomach yin, blood stagnation blocking stomach and damp-heat in spleen and stomach.

Essentials for Diagnosis 
(1) Repeated occurrence of chronic, periodic and rhymic epigastric burning, distending pain, dull pain, sharp pain and even colic. The attack is closely associated with food intake. Duodenal ulcer attacks between two meals and relieves after food intake. Gastric ulcer occurs within the first hour after meal and relieves afterwards and occurs again after the next meal.

(2) Acid regurgitation, heartburn, uncomfortable feeling of hungry, fullness sensation in the epigastrium, belching, nausea, vomiting and increase of salivation.

(3) During the attack, localized tenderness usually occurs in the epigastrium, which locates right in the ulcerative focus. In gastric ulcer, tenderness is in the left side of the epigastric region, while in duodenal ulcer, it is in the right side of the epigastric region.

(4) The circular or elliptical ulcertive areas may be seen through fibergastroscope which is smooth margin and flat-bottom and covered with white coats. The mucous membranes around the ulcer areas are slightly swelling and red. The detection of HP for most of the patients is positive. Niche and irritation may be seen in X-ray with barium meal, or the local membrane folds centralize to the niche.

(5) The test of stools occult blood examination is always positive in active stage. In most of the cases, it will turn into negative through 1 - 2 weeks of active treatment. In gastric juice analysis, the secretion of gastric juice is normal or slightly low in patients with gastric ulcer and always increased in patients with duodenal ulcer.