Helicobacter Pylori (H. Pylori) Infection

Diagnosis

Diagnosis of an H. pylori infection focuses on identifying the presence of H. pylori bacteria that cause symptoms such as stomach pain, bloating, or ulcers. Healthcare professionals may recommend one or more of the following tests:

• Stool tests:

  • Stool antigen test checks for specific proteins linked to H. pylori infections.

  • Stool PCR test uses polymerase chain reaction to detect H. pylori and identify antibiotic resistance genes. This test is more advanced but less widely available and more costly.

• Breath test:
  Also called a urea breath test, this method involves swallowing a solution containing tagged carbon molecules in urea. If H. pylori is present, the urea breaks down and releases carbon dioxide, which can be detected in the breath. This test is noninvasive and suitable for adults and children over six years old.

• Scope test (Upper endoscopy):
  During this test, a flexible tube with a camera, known as an endoscope, is guided through the throat to view the esophagus, stomach, and duodenum. Tissue samples may be collected for biopsy to confirm H. pylori infection. Although more invasive than other tests, an endoscopy helps identify ulcers and other digestive conditions and can guide antibiotic selection if previous treatments have failed.

Testing Considerations

Follow-up testing is important to confirm that the infection is cleared. Usually, these tests are done at least four weeks after completing antibiotics. Certain medications can interfere with test results, including:

• Proton pump inhibitors (PPIs)

• Histamine (H-2) blockers

• Bismuth subsalicylate (Pepto-Bismol)

Your healthcare provider will advise when to stop these medicines before testing.

The Role of Screening Tests

In areas where H. pylori and related complications are common, healthcare professionals may recommend screening even for people without symptoms. The benefits of such screening remain debated. However, if you have a high risk of stomach cancer or ulcers, screening and treatment may help reduce long-term risks.

Treatment

Treatment for H. pylori infections typically involves a combination of antibiotics and stomach-healing medications to eliminate the bacteria and promote recovery.

• Antibiotic therapy: At least two antibiotics are prescribed together to reduce resistance risk.

• Proton pump inhibitors (PPIs): Medicines such as omeprazole, esomeprazole, lansoprazole, or pantoprazole reduce stomach acid and support healing.

• Bismuth subsalicylate: Helps coat ulcers and protect them from acid damage.

• Histamine (H-2) blockers: Reduce stomach acid production, prescribed when PPIs cannot be used. Examples include cimetidine (Tagamet HB).

Follow-up testing about four weeks after treatment ensures the infection has been cleared. If H. pylori persists, additional treatment using different antibiotic combinations may be required to fully eradicate the infection.