Helicobacter pylori (H. pylori) is a common bacterium that can infect the stomach lining. While many individuals remain asymptomatic, H. pylori can damage the stomach tissue and the initial part of the small intestine, potentially leading to pain and inflammation.
When to Consider Testing
Individuals might consider H. pylori testing if they experience persistent digestive discomfort, such as a burning sensation in the upper stomach, indigestion, bloating, nausea, unexplained weight loss, frequent burping, or feeling full after consuming little food. These symptoms can indicate chronic gastritis, an inflammation of the stomach lining. H. pylori is also a primary cause of peptic ulcers, sores that can develop in the stomach or duodenum. Chronic H. pylori infection can also increase the risk of certain stomach cancers.
Available Testing Methods
Several methods are available to detect H. pylori infection, ranging from non-invasive to invasive procedures. Non-invasive options include the urea breath test and the stool antigen test. The urea breath test involves consuming a substance containing tagged carbon. If H. pylori is present, its urease enzyme breaks down the substance, releasing carbon dioxide detected in exhaled breath. The stool antigen test detects specific H. pylori proteins in a stool sample. Both tests are highly accurate for diagnosing current infections.
Blood antibody tests detect antibodies produced by the immune system in response to H. pylori. However, these tests indicate past or current exposure and cannot differentiate between an active and resolved infection. For a more definitive diagnosis, especially in complex cases, an upper endoscopy may be necessary. During an endoscopy, a flexible tube with a camera visualizes the stomach and duodenum, allowing for tissue collection (biopsy). Biopsy samples can undergo a rapid urease test, histology (microscopic examination), or bacterial culture to confirm infection.
Accessing H. Pylori Testing
Accessing H. pylori testing typically involves consulting a healthcare provider, such as a primary care physician. This doctor can evaluate symptoms and determine the most appropriate testing strategy. For non-invasive tests like the urea breath test or stool antigen test, a general practitioner can often order them, and the tests are usually performed at local laboratories or clinics. Many commercial labs offer these tests.
In situations requiring more in-depth assessment, such as persistent symptoms despite non-invasive test results or concerns about complications like ulcers, a referral to a gastroenterologist may be necessary. Gastroenterologists are specialists who perform invasive procedures like an upper endoscopy. This allows for direct visualization of the digestive tract and targeted tissue biopsies. While at-home H. pylori tests for breath or stool are available, professional medical consultation remains important for accurate interpretation of results and to guide appropriate treatment.
Preparing for Your Test and Interpreting Results
Proper preparation ensures accurate H. pylori test results. Before a urea breath test or stool antigen test, certain medications must be avoided. Antibiotics should be stopped at least four weeks prior, and proton pump inhibitors (PPIs) and bismuth-containing medications (like Pepto-Bismol) for one to two weeks beforehand. These medications can interfere with the test’s ability to detect the bacteria, potentially leading to false-negative results. For the urea breath test, fasting for at least one hour before the test is also commonly required.
A positive test result from a breath, stool, or endoscopy test indicates the presence of an active H. pylori infection. In this situation, a doctor will prescribe a course of antibiotics, often in combination with acid-reducing medications like PPIs, to eradicate the bacteria. Conversely, a negative test result suggests that H. pylori is likely not the cause of the symptoms. If symptoms persist despite a negative result, further discussion with the physician is recommended to explore other potential causes for the digestive issues.