Helicobacter Pylori Testing

H.pylori is a small bacterium that is found in the stomach lining of some people. For most it does not cause any trouble. However for those with duodenal ulcers and gastric ulcers, H.pylori needs to be eradicated before healing can occur.

What does Helicobacter pylori do?

As part of its normal activity the stomach produces acid. The inside of the stomach wall is protected from this by a thick layer of mucous. H.Pylori weakens this protective layer and also causes inflammation of the stomach lining. Over time some acid may get through and damage the lining of the stomach. This can lead to erosions which can lead to the following diseases;

  • Gastritis (inflammation of the lining of the stomach) – All people with H.pylori infection have inflammation but mostly without symptoms. In some people, this inflammation progresses to other diseases, but disappears if treated successfully.
  • Duodenal ulcers – H.pylori is the cause of about 90% of ulcers in the duodenum (beginning of small intestine). The most common symptom is pain the upper part of the abdomen.
  • Gastric (stomach) ulcers – H.pylori is the cause of about 70% of stomach ulcers.
  • Cancer of the stomach – H.pylori increases the risk of some forms of cancer of the stomach. Note: only a small minority of infected people ever develop this problem.

Who should be tested for Helicobacter pylori?

People who have had an ulcer or dyspepsia should be tested for H.pylori. Successful treatment of H.pylori will speed up ulcer healing and prevent recurrence.

How can I be tested for Helicobacter pylori?

  • Breath test – H.pylori in the stomach is able to convert a naturally occurring substance called urea into the gas carbon dioxide. If specially labelled urea is swallowed, labelled carbon dioxide can be detected for a short time in the breath which determines if the infection is present. This test is preferred for pregnant women or children and is useful to check eradication after treatment.

    You must have fasted for at least 6 hours before taking this test, stopped taking antibiotics at least 1 month before the test and stopped taking PPI (eg Losec, Omeprazole) at least 1 week before the test.

  • Blood test – This can detect current or recent infection but because the test can remain positive for several years after successful treatment, there are other more useful tests.
  • Stool Test – A stool sample can be used to determine if there is an active infection.
  • Gastroscopy – During a Gastroscopy the specialist can take small samples (biopsies) from the lining of the stomach which are sent to the laboratory for analysis. This test is very accurate and the preferred test.

How is Helicobacter pylori treated?

For complete healing and to restore the stomach lining to a healthy state, the H.pylori infection should be eliminated.

Treatment is usually oral drug therapy which includes an ulcer healing drug and two antibiotics. The success rate is 90% if taken as directed.

Eradication should be checked through either breath test or re-biopsy. These tests must be performed at least four weeks after all treatment is stopped, as H.pylori can grow again within this time. If the treatment has not been successful, a different combination of drugs may be tried.

Am I likely to become infected again?

No. The chance after successful treatment is only 0.5-1% per year.

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