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Helicobacter pylori (H. pylori) is a stealthy stomach resident, often lurking unnoticed. Yet, when it awakens, it can bring discomfort and even serious diseases. We will unravel the mysteries of H. pylori testing—what it involves, the types of tests available, and what you should know.

Understanding H. pylori Infection

H. pylori takes up residence in the human stomach, defying the odds by thriving in its acidic environment for years. Many infected individuals show no symptoms, but for some, it leads to nausea, stomach pain, bloating, loss of appetite, and bad breath. If left untreated, it can even cause ulcers and stomach cancer.

The H. pylori Test: What to Expect

When a healthcare provider suspects an H. pylori infection, they recommend a test. If the test confirms the presence of H. pylori, appropriate antibiotic therapy is prescribed. Usually, about 2-4 weeks after completing the antibiotic treatment, a follow-up H. pylori test is performed to check if the infection has been cleared.

There are several methods to detect H. pylori, including non-invasive options such as the urea breath test, blood test, and stool test, as well as an invasive method involving endoscopic examination and biopsy. The choice of test depends on your healthcare provider’s recommendation.

Exploring Different Types of H. pylori Tests

1. H. pylori Breath Test (Urea Breath Test)

Imagine a test that’s simple, painless, and delivers results in just a day. That’s the urea breath test for H. pylori. This test relies on an enzyme called urease, produced by H. pylori, which helps the bacterium survive in the stomach’s acidic environment.

Here’s how it works: You ingest a urea tablet containing a harmless carbon isotope called 13C. With the help of H. pylori‘s urease, this urea is broken down, producing carbon dioxide (13CO2), which can be exhaled later. Your exhaled breath is collected after taking the urea tablet, and the amount of carbon dioxide produced is measured. If more carbon dioxide is detected them expected, then the person may have an H. pylori infection.

To prepare for this test, you should avoid antibiotics and certain medications, fasting for six hours before the test. Not following these instructions could result in a false negative result.

This test serves both for diagnosis and for monitoring the effectiveness of therapy, offering reliable results.

2. H. pylori Blood Test

Another method for detection is the blood test, which checks for antibodies specific to H. pylori infection. Our immune system produces antibodies to combat invaders like bacteria.

There are different types of antibodies (IgM, IgG, IgA, etc.), each signalling a different stage of infection. IgM antibodies emerge early during an infection, while IgG antibodies appear as an infection is resolving. IgA antibodies are produced in specific mucous membranes and indicate current infection.

The H. pylori blood test is quick and involves taking a blood sample. However, it’s not the preferred primary diagnostic test for individuals who have previously been infected with H. pylori, as antibodies can persist even after the infection has been cleared.

3. H. pylori Stool Test

A highly effective and increasingly popular method for detecting H. pylori is the stool test. This involves examining stool samples for the presence of H. pylori antigens (HpSA test). Antigens are substances our immune system recognizes as invaders.

This non-invasive test provides precise results by measuring H. pylori antigens in the stool, which pass through the digestive system and into the feces. It’s a preferred option for both diagnosing current H. pylori infection and monitoring treatment effectiveness. A negative result after therapy indicates successful eradication.

For the most reliable results, it’s recommended to take the H. pylori stool test about four weeks after completing therapy.

4. Invasive H. pylori Test – Biopsy

Reliable, but invasive method is obtaining stomach tissue samples during an endoscopic examination (gastroscopy). Various techniques, such as staining, urease testing, culturing, or PCR, are then used to identify H. pylori in the tissue.

If used for monitoring treatment effectiveness, just like other tests, this should be conducted about four weeks after completing therapy.

Understanding H. pylori testing is essential for timely diagnosis and treatment. Your healthcare provider will recommend the most suitable test based on your symptoms and medical history. Early detection and appropriate treatment can help you bid farewell to this elusive stomach guest.

Author: dr Ivana Beara, PhD in Biochemistry