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Helicobacter Pylori (H. Pylori) Tests

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What are helicobacter pylori (H. pylori) tests?

Helicobacter pylori (H. pylori) is a type of bacteria that infects the digestive system. Many people with H. pylori will never have symptoms of infection. But for others, the bacteria can cause a variety of digestive disorders. These include gastritis (inflammation of the stomach), peptic ulcers (sores in the stomach, small intestine, or esophagus), and certain types of stomach cancer.

There are different ways to test for an H. pylori infection. They include blood, stool, and breath tests. If you are having digestive symptoms, testing and treatment may help prevent serious complications.

Other names: H. pylori stool antigen, H. pylori breath tests, urea breath test, rapid urease test (RUT) for H. pylori, H. pylori culture

What are they used for?

H. pylori tests are most often used to:

  • Look for H. pylori bacteria in the digestive tract
  • Find out if your digestive symptoms are caused by an H. pylori infection
  • Find out if treatment for an H. pylori infection has worked

Why do I need an H. pylori test?

You may need testing if you have symptoms of a digestive disorder. Since gastritis and ulcers both inflame the lining of the stomach, they share many of the same symptoms. They include:

  • Abdominal pain
  • Bloating
  • Nausea and vomiting
  • Diarrhoea
  • Loss of appetite
  • Weight loss

An ulcer is a more serious condition than gastritis, and symptoms are often more severe. Treating gastritis in early stages may help prevent the development of an ulcer or other complications.

What happens during H. pylori testing?

There are different ways to test for H. pylori. Your health care provider may order one or more of the following types of tests.

Blood test

  • Checks for antibodies (infection-fighting cells) to H. pylori
  • Test procedure:
    • A health care professional will take a blood sample from a vein in your arm, using a small needle.
    • After the needle is inserted, a small amount of blood will be collected into a test tube or vial.

Breath test, also known as a urea breath test

  • Checks for infection by measuring certain substances in your breath
  • Test procedure:
    • You will provide a sample of your breath by breathing into a collection bag.
    • After that, you will swallow a pill or liquid containing a harmless radioactive material.
    • You will provide another sample of your breath.
    • Your provider will compare the two samples. If the second sample has higher than normal carbon dioxide levels, it is a sign of an H. pylori infection.
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Stool tests.Your provider may order a stool antigen or a stool culture test.

  • A stool antigen test looks for antigens to H. pylori in your stool. Antigens are substances that trigger an immune response.
  • A stool culture test looks for H. pylori bacteria in the stool.
  • Samples for both types of stool tests are collected in the same way. Sample collection usually includes the following steps:
    • Put on a pair of rubber or latex gloves.
    • Collect and store the stool in a special container given to you by your health care provider or a lab.
    • If collecting a sample from a baby, line the baby’s diaper with plastic wrap.
    • Make sure no urine, toilet water, or toilet paper mixes in with the sample.
    • Seal and label the container.
    • Remove the gloves, and wash your hands.
    • Return the container to your health care provider.

Endoscopy. If other tests did not provide enough information for a diagnosis, your provider may order a procedure called an endoscopy. Endoscopy allows your provider to look at your esophagus (the tube that links your mouth and stomach), the lining of your stomach, and part of your small intestine. During the procedure:

  • You will lie down on an operating table on your back or side.
  • You will be given medicine to help you relax and prevent you from feeling pain during the procedure.
  • Your provider will insert a thin tube, called an endoscope, into your mouth and throat. The endoscope has a light and camera on it. This allows the provider to get a good view of your internal organs.
  • Your provider may take a biopsy (removal of a small sample of tissue) to examine after the procedure.
  • After the procedure, you will be observed for an hour or two while the medicine wears off.
  • You may be drowsy for a while, so plan to have someone drive you home.

Will I need to do anything to prepare for testing?

  • You don’t need any special preparation for an H. pylori blood test.
  • For breath, stool, and endoscopy tests, you may need to stop taking certain medicines for as long as two weeks to a month before testing. Be sure to talk with your health care provider about all medicines you are currently taking.
  • For an endoscopy, you may need to fast (not eat or drink) for about 12 hours before the procedure.
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Are there any risks to testing?

There is very little risk of having a blood test. You may have slight pain or bruise at the spot where the needle was put in, but most symptoms go away quickly.

There is no known risk to having breath or stool tests.

During an endoscopy, you may feel some discomfort when the endoscope is inserted, but serious complications are rare. There is a very small risk of getting a tear in your intestine. If you had a biopsy, there is a small risk of bleeding at the site. Bleeding usually stops without treatment.

What do the results mean?

If your results were negative, it means you probably don’t have an H. pylori infection. Your provider may order more tests to find out the cause of your symptoms.

If your results were positive, it means you have an H. pylori infection. H. pylori infections are treatable. Your health care provider will probably prescribe a combination of antibiotics and other medicines to treat the infection and relieve pain. The medicine plan can be complicated, but it’s important to take all the medicines as prescribed, even if your symptoms go away. If any H. pylori bacteria remain in your system, your condition can worsen. Gastritis caused by H. pylori can lead to a peptic ulcer and sometimes stomach cancer.

Is there anything else I need to know about H. pylori testing?

After you’ve been treated with antibiotics, your health care provider may order repeat tests to make sure all the H. pylori bacteria is gone.

References

  1. American Gastroenterological Association [Internet]. Bethesda (MD): American Gastroenterological Association; c2019. Peptic Ulcer Disease; [cited 2019 Jun 27]; [about 3 screens]. Available from: https://www.gastro.org/practice-guidance/gi-patient-center/topic/peptic-ulcer-disease
  2. Kids Health from Nemours [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2019. Helicobacter pylori; [cited 2019 Jun 27]; [about 2 screens]. Available from: https://kidshealth.org/en/parents/h-pylori.html
  3. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2019. Helicobacter pylori (H. pylori) Testing; [updated 2019 Feb 28; cited 2019 Jun 27]; [about 2 screens]. Available from: https://labtestsonline.org/tests/helicobacter-pylori-h-pylori-testing
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  6. The Ohio State University: Wexner Medical Center [Internet]. Columbus (OH): The Ohio State University, Wexner Medical Center; H. Pylori Gastritis; [cited 2019 Jun 27]; [about 5 screens]. Available from: https://wexnermedical.osu.edu/digestive-diseases/h-pylori-gastritis
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  8. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Tests for H. pylori: Overview; [updated 2019 Jun 27; cited 2019 Jun 27]; [about 2 screens]. Available from: https://ufhealth.org/tests-h-pylori
  9. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Helicobacter Pylori; [cited 2019 Jun 27]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=P00373
  10. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Helicobacter Pylori Antibody; [cited 2019 Jun 27]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=helicobacter_pylori_antibody
  11. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Helicobacter Pylori Culture; [cited 2019 Jun 27]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=helicobacter_pylori_culture
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Helicobacter Pylori Tests: How It Is Done; [updated 2018 Nov 7; cited 2019 Jun 27]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/helicobacter-pylori-tests/hw1531.html#hw1554
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  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Helicobacter Pylori Tests: Why It Is Done; [updated 2018 Nov 7; cited 2019 Jun 27]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/helicobacter-pylori-tests/hw1531.html#hw1544
  17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Upper Gastrointestinal Endoscopy: How It Is Done; [updated 2018 Nov 7; cited 2019 Jun 27]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/upper-gastrointestinal-endoscopy/hw267678.html#hw267713
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