At a glance

Also known as

H. pylori antibody test; H. pylori antigen test; H. pylori breath test

Why get tested?

To diagnose an infection with Helicobacter pylori

When to get tested?

If you have gastrointestinal pain or symptoms of an ulcer

Sample required?

A breath test, tissue biopsy of the stomach lining via gastroscopy, stool sample, or blood sample from a vein

Test preparation needed?

None for the blood test; there are instructions for the breath test; specialised preparation is needed for a gastroscopy

What is being tested?

These tests are looking for evidence of an infection by a bacterium, known as Helicobacter pylori. This bacterium is now known to be a major cause of peptic ulcer disease. H. pylori is also associated with the development of gastric cancer.

How is the sample collected for testing?

What is collected depends on the test your doctor requests. It may be as simple as submitting a stool (faecal) sample to look for the H. pylori antigen or a blood sample from your vein to detect an antibody to the bacteria.

A more invasive test will require a procedure called an endoscopy or gastroscopy, which means putting a tube down the throat into the stomach to take a small piece of tissue (a biopsy) from the stomach lining. A biopsy can be used to detect other reasons for stomach pain, as well as be tested in the laboratory for H. pylori. H. pylori produces urease, a special enzyme that allows it to survive in the acidic environment of the stomach.

The laboratory can detect the presence of this bacterium by looking for this enzyme in the tissue sample. The tissue may also be examined under a microscope by a pathologist, who will look for these bacteria or any other signs of disease that may explain your symptoms.

Sometimes a breath test can be used instead of a biopsy. You will be asked to drink a special liquid containing a harmless radioactive material. If H. pylori is present in your GI tract, the material will be broken down into radio-labelled carbon dioxide gas. By testing the expelled air collected from your breath sample, the laboratory can determine if this organism is in your body.

The Test

How is it used?

A positive test for H. pylori indicates that your gastrointestinal pain may be caused by this bacterium. Taking antibiotics will kill the bacteria and may stop the pain and the ulceration.

When is it requested?

If you come in complaining of gastrointestinal pain and symptoms of an ulcer, your doctor may request one of the H. pylori tests to determine if there is evidence of this disease. These tests may also be requested after you finish taking the prescribed antibiotics to prove that the H. pylori bacteria have disappeared from your body. A follow-up test is not performed on every patient.

What does the test result mean?

A positive H. pylori test, antibody, antigen, or breath test indicates that you have been infected with this organism. In recent years, scientific data show that this bacteria causes stomach ulcers and appropriate treatment can destroy the bacteria and stop the disease.

Is there anything else I should know?

People have gastrointestinal pain for many reasons - H. pylori is only one.

Being on proton pump inhibitor medications such as pantoprazole and omeprazole can decrease the sensitivity of the tests and should be ceased two weeks prior to the test being performed.

Common Questions

What is the treatment of H. pylori-caused peptic ulcer?

Usually the doctor will prescribe a combination of antibiotics and proton pump inhibitor medications for several days.

Does everyone with H. pylori get ulcers?

No, many people have evidence of infection but have no symptoms of ulcerative disease.

How did I get infected with H. pylori?

The bacteria are transmitted by eating food or drinking water that has been contaminated with human faecal material. Animals do not carry the bacteria in their gastrointestinal (GI) tracts; it is only found in humans. Peptic ulcer disease is one of the most common human ailments, affecting about 50% of the world's population. In Australia and other developed countries, the infection rate is lower because of better hygiene and socioeconomic status. Person to person spread can occur within households.

Does everyone treated for H. pylori get better?

The majority of persons who successfully complete the combination antibiotic therapy get rid of this bacterium from their GI tract. However, resistance to some of the antibiotics may occur and therefore the bacteria may continue to multiply in spite of appropriate therapy.

My father had an ulcer and he only took antacids. Why do I need antibiotics?

Years ago doctors did not know that Helicobacter pylori existed. Before 1994, peptic ulcers were not recognised as an infectious disease, so the only treatment prescribed for ulcers was a change in diet and antacids to stop the pain.

Last Review Date: October 4, 2022

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