H. Pylori Gastric Infection Testing

What is H. pylori gastric infection testing?

Helicobacter pylori (H. pylori) is a type of bacteria that lives in the stomach lining. Although it can be present in the digestive tract without causing problems, it may sometimes lead to infection of the stomach lining. While some people infected with H. pylori may not show symptoms, others may develop stomach ulcers, gastritis, or more serious digestive issues. This infection is quite common and often begins in childhood. Left untreated, H. pylori can lead to long-term complications.

Testing for H. pylori helps detect the bacteria's presence in the body. Early testing allows doctors to begin treatment before symptoms worsen. This diagnostic test might benefit patients experiencing persistent stomach discomfort, indigestion, or a history of gastric issues.

Several methods are available for detecting H. pylori. The urea breath test is non-invasive and commonly used. Stool antigen tests check for signs of the bacteria in a patient’s stool. Blood tests may detect antibodies, though they are less accurate for active infection. In some cases, endoscopy is recommended, where a small camera is used to examine the stomach lining and collect a sample for testing. Choosing the correct testing method can be challenging, but doctors can guide patients to get the most suitable test for their condition.

Why is H. pylori testing necessary?

Testing for H. pylori is important in managing and preventing severe gastric conditions. The infection is linked to the development of peptic ulcers and chronic gastritis. If left untreated, it may even increase the risk of stomach cancer in some individuals.

Early detection of H. pylori means that treatment can begin before complications arise. Treating H. pylori infection can relieve symptoms like stomach pain, bloating, and indigestion. It also reduces the chances of the infection reoccurring or causing long-term damage to the stomach lining.

Testing offers peace of mind for patients with unexplained digestive symptoms or a history of ulcers. It is also a preventive measure for those with a family history of stomach cancer. In many cases, treatment is simple and effective, often involving a course of antibiotics and acid-reducing medication.

Am I suitable for H. pylori testing?

You may be suitable for H. pylori testing if you experience frequent stomach pain, a burning sensation in the upper abdomen, bloating, nausea, or unexplained weight loss. These symptoms can suggest an infection, especially if they persist over a few days.

People with a history of peptic ulcers or chronic gastritis might be recommended to test for H. pylori infection. If you have a family member with stomach cancer, your doctor may also recommend testing as a precaution. Lifestyle factors, such as living in crowded or unsanitary conditions during childhood, can increase the risk of infection.

Your doctor will decide whether testing is needed based on your symptoms, medical history, and risk factors. In some cases, testing is advised before starting long-term use of certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), which can irritate the stomach lining if H. pylori is present.

Preparing for an H. pylori test

Patient performing H. pylori breath test using a diagnostic bag

Preparation for the H. pylori test depends on the method your doctor recommends. For most types, including the breath and stool tests, you may need to stop taking certain medications briefly. This usually includes antibiotics, proton pump inhibitors (PPIs), and antacids, as they can affect the accuracy of your results.

Your doctor will let you know which medicines you need to stop temporarily. For the urea breath test, you may also be asked to avoid eating or drinking for at least six hours before the procedure. This is to ensure that the stomach is empty for more accurate results.

If you are scheduled for an endoscopy, fasting is often required from the night before. You may also be asked to arrange for someone to accompany you home, as sedatives are sometimes used. It is important to follow the specific instructions given by your doctor.

What to expect during the test: Is it uncomfortable?

Gloved hand holding a blood sample labeled Helicobacter Pylori, representing testing and consideration for repeating H. pylori treatment

Several testing options are available for H. pylori. The urea breath test is one of the most common and noninvasive methods. You will be asked to blow into a small bag, drink a substance containing tagged carbon molecules, and then blow into a second bag after a short wait. The bags are then tested for traces of carbon dioxide, which helps detect the presence of H. pylori. This test is painless and can be completed in under 30 minutes.

The stool antigen test involves sending a small sample of your stool to a lab for analysis. This test is also non-invasive and can be done at home or in a clinic, depending on your doctor's instructions.

The blood test requires a simple blood draw, which may cause slight discomfort at the needle site. However, it is not usually painful.

In some cases, your doctor might advise an endoscopy, especially when symptoms are severe or ongoing. During this procedure, a thin, flexible tube with a camera is passed through your mouth and inserted into your stomach. You may be given a mild sedative to help you relax. You might feel slight pressure or discomfort, but the process is typically tolerable.

After the test: What happens next?

After the H. pylori test, most people can return to their usual activities immediately. There are generally no restrictions if you have a breath, stool, or blood test. You may eat and drink as normal unless your doctor advises otherwise.

If you underwent an endoscopy, you might feel sleepy or have a sore throat for a few hours. You should rest for the remainder of the day and avoid driving or operating heavy machinery, especially if you were given sedation. You may eat once the numbness in your throat wears off.

Your doctor will explain when to expect your results and whether any follow-up is needed. If treatment is necessary, your doctor will discuss the next steps with you in detail. Be sure to inform your doctor if you notice any unusual symptoms after the test, especially if you had an endoscopy.

Are there any side effects? How long is the recovery?

For most types of H. pylori tests, side effects are minimal. Breath, stool, and blood tests are noninvasive and usually do not require any recovery time. You can return to your normal routine afterwards.

If you had an endoscopy, the sedative might make you tired or slightly unwell for a few hours. Some patients experience a mild sore throat or bloating after the procedure. These symptoms typically go away within a day. It is best to rest after the procedure and follow any advice given by your doctor about consuming food or drink.

When will I receive my results?

The time it takes to receive your results will depend on your test type. Breath and stool test results are usually available within a few days. Blood test results might take slightly longer. If you had an endoscopy, the sample taken during the procedure will be analysed in a laboratory, and results may take up to a week.

Your doctor will inform you of the results once they are available. If your test is positive, your doctor will discuss the best treatment plan to clear the infection.

Should I repeat H. pylori testing in the future?

In most cases, repeat testing is only needed if you have been treated for H. pylori. Your doctor may recommend a follow-up breath or stool test around four weeks after treatment to confirm the infection has been cleared.

If your symptoms return or do not improve, repeat testing may be advised to check for re-infection. Ongoing symptoms, especially in patients with a history of ulcers or gastric issues, may also prompt further investigation. Regular testing is usually not required unless your risk of infection is high or you develop new symptoms.

Visit ACE to test for H. pylori gastric infection

To confirm or rule out gastric infection caused by H. pylori, please schedule an appointment with an ACE Specialist for Surgery and Endoscopy today. Our Senior Gastrointestinal specialist, Dr Reyaz Singaporewalla, will assess your condition and determine if H. pylori gastric infection testing is necessary to confirm or rule out a potential infection.

References:

  1. Lee YC, Dore MP, Graham DY. Diagnosis and Treatment of Helicobacter pylori Infection. Annu Rev Med. 2022;73:183-195. doi: 10.1146/annurev-med-042220-020814
  2. Guevara B, Cogdill AG. Helicobacter pylori: A Review of Current Diagnostic and Management Strategies. Dig Dis Sci. 2020;65:1917-1931. doi: 10.1007/s10620-020-06193-7
  3. Yang H, Hu B. Diagnosis of Helicobacter pylori Infection and Recent Advances. Diagnostics. 2021;11(8):1305-1319. doi: 10.3390/diagnostics11081305
  4. Shatila M, Thomas AS. Current and Future Perspectives in the Diagnosis and Management of Helicobacter pylori Infection. J Clin Med. 2022;11(17):5086. doi: 10.3390/jcm11175086

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Reyaz Moiz

Dr Reyaz Singaporewalla
Senior Gastrointestinal Specialist and General Surgeon   

MBBS (Bom), MS (Surg), DNB (Surg), FRCS (Edin), MMed (Singapore), FRCSEd.