H. pylori (Helicobacter pylori) is a type of bacteria commonly found in the stomach. Almost half of all people have H. pylori in their bodies but never develop symptoms or problems related to the bacteria.
However, in some people, H. pylori can cause digestive problems, including ulcers or chronic inflammation in the walls of the stomach (gastritis) or duodenum (duodenitis). Rarely, H. pylori can cause stomach cancer.
H. pylori may be diagnosed with a number of different tests:
- Breath tests (urea breath tests): patients drink a specialized solution containing a substance broken down by the H. pylori bacterium and the breakdown products can be detected in a person’s breath
- Stool tests to detect H. pylori proteins in bowel movements
- Blood tests to detect specific antibodies (proteins) that the body's immune system develops in response to the H. pylori bacterium (not widely used due to concerns over its accuracy)
There are also home breath tests and stool tests for H. pylori. These tests are non-invasive.
For breath tests: Patients should follow all instructions on the package and from their doctor on test administration. Patients may be given breath test kits by their doctor to administer at home. General guidelines for H. pylori breath tests:
- For accurate results, patients must avoid certain medications for two weeks before testing, including:
- Proton pump inhibitors (PPIs)
- Bismuth preparations such as Pepto Bismol
- Fast for at least one hour before starting the test (no food or beverages)
- Patients then collect a baseline breath sample by exhaling into a designated bag, and then sealing the bag as instructed
- Patients then prepare a non-radioactive form of C urea, and drink as instructed
- In the presence of H. pylori, urea is converted by the bacterial enzyme urease to CO2 and ammonia
- The CO2 is absorbed in the blood and exhaled in the breath
- Wait 15 minutes
- Collect a second breath sample in a designated bag and seal
- Samples are then mailed to a lab to process results
- Results are usually sent to your doctor
For stool tests: Patients should follow all instructions on the package on test administration. Stool tests may be given to patients by their doctor and some can be purchased online. General guidelines for H. pylori stool tests:
- Fasting is not necessary for stool testing
- Patients should avoid use of laxatives, antacids, or anti-diarrheal medications for at least one week before collecting the specimen
- Urinate first into the toilet if needed
- Collect the stool specimen in into the sterile cup provided by lab
- The stool specimen should not come in contact with water or urine
- Using the applicator stick, fill the provided container half full, taking care not to touch the inside of the lid or container with your fingers
- Seal the container in the zip locked section of the bag and requisition in the pouch section of the bag
- Wash your hands with soap and water
- Bring the container and any paperwork to the lab as soon as possible (within 18 hours)
- Keep the sample refrigerated until it is brought to the lab
What Are Symptoms of H. Pylori?
Most people who have H. pylori infection have no symptoms but some people can develop serious problems, including stomach or duodenal ulcers.
Symptoms of ulcers include:
- Abdominal pain or discomfort
- Feeling of fullness after eating small amounts
- Loss of appetite
- Nausea or vomiting
- Dark or tar-colored stools
- Ulcers that bleed can cause low blood count and fatigue
Rarely, H. pylori can cause chronic gastritis that results in abnormal changes in the stomach lining, which can lead to stomach cancer.
What Is the Treatment for H. Pylori?
Treatment for H. pylori infection usually involves taking several medications for 14 days.
- Proton pump inhibitors (PPIs) to decrease the stomach acid production
- Two antibiotics are usually recommended along with a PPI to reduce the risk of treatment failure and antibiotic resistance
Many patients with H. pylori have an antibiotic-resistant infection, so it is important to take the entire course of all medications prescribed and to get a blood or stool test to confirm the infection has been cleared.
Up to 20% of patients with H. pylori infection are not cured after completing one course of treatment and it is necessary to re-treat the infection.
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