Helicobacter Pylori - Diagnosis

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How was the diagnosis of your helicobacter pylori established?

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How is H. pylori infection diagnosed?

Accurate and simple tests for the detection of H. pylori infection are available. They include blood antibody tests, urea breath tests, stool antigen tests, and endoscopic biopsies.

Blood tests for the presence of antibodies to H. pylori can be performed easily and rapidly. However, blood antibodies can persist for years after complete eradication of H. pylori with antibiotics. Therefore, blood antibody tests may be good for diagnosing infection, but they are not good for determining if antibiotics have successfully eradicated the bacterium.

The urea breath test (UBT) is a safe, easy, and accurate test for the presence of H. pylori in the stomach. The breath test relies on the ability of H. pylori to break down the naturally occurring chemical, urea, into carbon dioxide which is absorbed from the stomach and eliminated from the body in the breath. Ten to 20 minutes after swallowing a capsule containing a minute amount of radioactive urea, a breath sample is collected and analyzed for radioactive carbon dioxide. The presence of radioactive carbon dioxide in the breath (a positive test) means that there is active infection. The test becomes negative (there is no radioactive carbon dioxide in the breath) shortly after eradication of the bacterium from the stomach with antibiotics. Since some individuals are concerned about even minute amounts of radioactivity the breath test has been modified so that it also may be performed with urea that is not radioactive.

Endoscopy is an accurate test for diagnosing H. pylori as well as the inflammation and ulcers that it causes. For endoscopy, the doctor inserts a flexible viewing tube (endoscope) through the mouth, down the esophagus, and into the stomach and duodenum. During endoscopy, small tissue samples (biopsies) from the stomach lining can be removed. A biopsy specimen is placed on a special slide containing urea (for example, CLO test slides). If the urea is broken down by H. pylori in the biopsy, there is a change in color around the biopsy on the slide. This means that there is an infection with H. pylori in the stomach.

Biopsies also may be cultured in the bacteriology laboratory for the presence of H. pylori; however, this is done infrequently since other simpler tests are available.

A recently-developed test for H. pylori is a test in which the presence of the bacterium can be diagnosed with a sample of stool. The test uses an antibody to H. pylori to determine if H. pylori is present in the stool. If it is, it means that H. pylori is infecting the stomach. Like the urea breath test, in addition to diagnosing infection with H. pylori, the stool test can be used to determine if eradication has been effective shortly after treatment.

In 2012, the FDA gave approval for the urea breath test to be done in children aged 3 years to 17 years old.

Return to Helicobacter Pylori (H pylori)

See what others are saying

Comment from: Charlene, 75 or over Female (Patient) Published: December 06

I was rushed to hospital with extremely low blood count and little iron in my system. I was given 2 units of blood and one of iron. I had colonoscopy of upper gastro intestinal tract with camera capsule. They all showed some places that were probably slow bleeders. Then they found the Helicobacter pylori bacteria. I had gotten so week so slowly that it seemed to have crept up on me. I took the round of antibiotics.

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Comment from: GenieB, 55-64 Female (Patient) Published: January 21

I have two siblings that were diagnosed with stomach cancer in their 50s. One sibling died in August 2013. I had been having a few issues with bloating, stomach pain and real bad indigestion that was getting progressively worse over the last year. I talked to my primary physician assistant in my physician's office about my two siblings and she suggested to me as did my gynecologist, to be tested. My physician assistant referred me to a gastroenterologist who performed an endoscopy. The results were that I had an inflamed stomach lining and helicobacter pylori. I was on the triple therapy (amoxicillin, Flagyl and omeprazole) for 2 weeks. The H. pylori was eradicated after a subsequent urea breath test was administered.

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