Diagnostic test in which Helicobacter pylori, the bacterium responsible for gastric ulcers and gastritis, is detected by invasive or non-invasive methods.
Indication
- Recurrent stomach pain or indigestion (dyspepsia) complaints
- History of gastric or duodenal (peptic) ulcer
- Patients with iron deficiency anemia of unclear etiology
- Screening in individuals with a family history of gastric cancer
- Patients planned for long-term aspirin or non-steroidal anti-inflammatory drug (NSAID) use
- Verification of eradication success in patients previously treated for H. pylori
- Suspected MALT lymphoma or its treatment follow-up
Preparation
- Proton pump inhibitors (PPIs) are stopped at least 2 weeks before the urea breath test or stool antigen test
- Antibiotics or bismuth-containing medications must be stopped 4 weeks before the test
- Fasting for 6-8 hours is required if endoscopic biopsy is planned
- Use of blood thinners must be reported to the physician
- On the morning of the test, no food intake other than water is recommended
How it's performed
- The method is determined by the physician: blood test, stool antigen, urea breath test, or endoscopic biopsy
- In non-invasive tests, the sample (blood, stool, or breath) is sent to the laboratory
- In the endoscopic method, a small tissue sample taken from the stomach is sent for rapid urease testing (CLO) or pathological examination
- Results are available the same day or within 1-3 business days depending on the test type
- A positive result indicates the presence of the bacterium; a negative result indicates absence or successful treatment
Post-procedure
- If positive, the physician plans eradication therapy (usually a 14-day quadruple regimen)
- Verification with a urea breath test or stool antigen test is recommended 4-8 weeks after treatment
- PPIs and antibiotics must again be stopped before the verification test
- If treatment fails, alternative antibiotic combinations are considered
- If complaints persist, further evaluation (endoscopy) is considered
Risks
- Throat irritation and temporary difficulty swallowing during endoscopic biopsy
- Very rarely, minor bleeding at the biopsy site
- Antibody (blood) tests may also be positive for past infections; active infection cannot be distinguished
- Recent PPI/antibiotic use may lead to false-negative results
- Very rarely, sedation-related reactions during endoscopy
FAQ
Which test is more reliable?
For active infection, the urea breath test and stool antigen test are the most accurate non-invasive methods. If endoscopy is required, biopsy-based tests are considered the gold standard.
Why do I need to stop my medications before the test?
Proton pump inhibitors and antibiotics temporarily suppress the bacterium, which can lead to false-negative results.
What happens if it is positive?
If the result is positive, the physician usually recommends a 14-day multi-antibiotic combination (quadruple therapy). A verification test is recommended after treatment.
Should family members also be tested?
Testing may be considered for individuals living in the same household who have complaints or risk factors. General screening is not mandatory for the entire family.
Related Information
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Urea Breath Test
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Urea breath test — a non-invasive diagnostic test that detects Helicobacter pylori in a breath sample.
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Upper GI endoscopy (gastroscopy) — visualization of the esophagus, stomach, and duodenum.
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Gastric surgery — total and subtotal gastrectomy for the treatment of gastric cancer and complex stomach diseases.
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General internal medicine consultation — diagnosis, follow-up, and referral of systemic conditions in adults.
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