- H. pylori & Breath Test
- Heliobacter Pylori Testing
- Tests for H. Pylori
- Alternative Names
- How the test is performed
- Why the test is performed
- Normal Values
- What abnormal results mean
- Stool Test: H. Pylori Antigen
- Why It's Done
- What to Expect
- Getting the Results
- Helping Your Child
- If You Have Questions
- H. pylori: Causes, Symptoms, Treatment
- Helicobacter pylori
- Signs and Symptoms
- When to Call the Doctor
- Helicobacter Pylori (H. Pylori) Tests: MedlinePlus Lab Test Information
H. pylori & Breath Test
What is a peptic ulcer?
A peptic ulcer is a sore on the lining of the stomach or duodenum, the beginning of the small intestine. Less commonly, a peptic ulcer may develop just above the stomach in the esophagus, the tube that connects the mouth to the stomach.
A peptic ulcer in the stomach is called a gastric ulcer. One that occurs in the duodenum is called a duodenal ulcer. People can have both gastric and duodenal ulcers at the same time. They also can develop peptic ulcers more than once in their lifetime.
Peptic ulcers are common. Each year in the United States, about half a million people develop a peptic ulcer.
What causes peptic ulcers?
A bacterium called Helicobacter pylori (H. pylori) is a major cause of peptic ulcers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are another common cause. Rarely, cancerous or noncancerous tumors in the stomach, duodenum, or pancreas cause ulcers.
Peptic ulcers are not caused by stress or eating spicy food, but both can make ulcer symptoms worse. Smoking and drinking alcohol also can worsen ulcers and prevent healing.
What is H. pylori?
H. pylori is a type of bacteria—a germ that may cause infection. H. pylori infection is common, particularly in developing countries, and often begins in childhood. Symptoms usually don’t occur until adulthood, although most people never have any symptoms.
H. pylori causes more than half of peptic ulcers worldwide. The bacterium causes peptic ulcers by damaging the mucous coating that protects the stomach and duodenum. Damage to the mucous coating allows powerful stomach acid to get through to the sensitive lining beneath. Together, the stomach acid and H. pylori irritate the lining of the stomach or duodenum and cause an ulcer.
Yet, most people infected with H. pylori never develop ulcers. Why the bacterium causes ulcers in some people and not in others is not known. Most ly, development of ulcers depends on characteristics of the infected person; the type, or strain, of H. pylori present; and factors researchers have yet to discover.
How is H. pylori spread?
Researchers are not certain how H. pylori is transmitted, although they think it may be spread through contaminated food or water. People may pick up the bacterium from food that has not been washed well or cooked properly or from drinking water that has come from an unclean source.
Other research is exploring how infection spreads from an infected person to an uninfected person. Studies suggest that having contact with the stool or vomit of an infected person can spread H. pylori infection. And H. pylori has been found in the saliva of some infected people, which means infection could be spread through direct contact with saliva.
What are the symptoms of a peptic ulcer?
Abdominal discomfort is the most common symptom of both duodenal and gastric ulcers. Felt anywhere between the navel and the breastbone, this discomfort usually
- is a dull or burning pain
- occurs when the stomach is empty—between meals or during the night
- may be briefly relieved by eating food, in the case of duodenal ulcers, or by taking antacids, in both types of peptic ulcers
- lasts for minutes to hours
- comes and goes for several days or weeks
Other symptoms include
- weight loss
- poor appetite
Some people experience only mild symptoms or none at all.
A person who has any of the following symptoms should call a doctor right away:
- sharp, sudden, persistent, and severe stomach pain
- bloody or black stools
- bloody vomit or vomit that looks coffee grounds
These “alarm” symptoms could be signs of a serious problem, such as
- bleeding—when acid or the peptic ulcer breaks a blood vessel
- perforation—when the peptic ulcer burrows completely through the stomach or duodenal wall
- obstruction—when the peptic ulcer blocks the path of food trying to leave the stomach
How is an H. pylori-induced ulcer diagnosed?
If a patient has peptic ulcer symptoms, the doctor first asks about use of over-the-counter and prescription NSAIDs. Patients who are taking an NSAID are asked to stop, reduce the dose, or switch to another medication.
Then the doctor tests to see if H. pylori is present. Testing is important because H. pylori-induced ulcers are treated differently than ulcers caused by NSAIDs.
Doctors use one of three simple, noninvasive tests to detect H. pylori in a patient’s blood, breath, or stool. Because the breath test and stool test more accurately detect H. pylori than the blood test, some doctors prefer to use one of these two tests. Each test described below is easily performed, often in an outpatient setting such as a doctor’s office or lab.
Blood test. A blood sample is taken from the patient’s vein and tested for H. pylori antibodies. Antibodies are substances the body produces to fight invading harmful substances—called antigens—such as the H. pylori bacterium.
Urea breath test. The patient swallows a capsule, liquid, or pudding that contains urea “labeled” with a special carbon atom.
After a few minutes, the patient breathes into a container, exhaling carbon dioxide. If the carbon atom is found in the exhaled breath, H.
pylori is present, as this bacterium contains large amounts of urease, a chemical that breaks urea down into carbon dioxide and ammonia.
Stool antigen test. The patient provides a stool sample, which is tested for H. pylori antigens.
If a patient has any alarm symptoms, the doctor orders an endoscopy or upper gastrointestinal (GI) series. Many doctors also recommend these tests for patients who first experience peptic ulcer symptoms around age 50. Often performed as outpatient procedures in a hospital, both procedures are painless and allow the doctor to look inside the patient’s stomach and duodenum.
For an endoscopy, the patient is lightly sedated. The doctor passes an endoscope—a thin, lighted tube with a tiny camera on the end—into the patient’s mouth and down the throat to the stomach and duodenum. With this tool, the doctor can closely examine the lining of the esophagus, stomach, and duodenum.
The doctor can use the endoscope to take photos of ulcers or remove a tiny piece of tissue—no bigger than a match head—to view with a microscope. This procedure is called a biopsy. The biopsied tissue is examined to see if H. pylori is present.
If an ulcer is bleeding, the doctor can use the endoscope to inject medicines that help the blood clot or to guide a heat probe that burns tissue to stop bleeding—a process called cauterization.
For an upper GI series, the patient drinks a white, chalky liquid called barium. The barium makes the esophagus, stomach, and duodenum and any ulcers show up on an x ray. Sedation is not necessary for this procedure.
How is an H. pylori-induced ulcer treated?
Peptic ulcers caused by H. pylori are treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach and duodenal lining.
Antibiotics are used to kill H. pylori. Antibiotic regimens may differ throughout the world because some strains of H.
pylori have become resistant to certain antibiotics—meaning that an antibiotic that once destroyed the bacterium is no longer effective. Doctors closely follow research on antibiotic treatments for H.
pylori infection to know which treatment strategy will destroy which strain.
Medicines that reduce stomach acid include proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). Both acid-reducing medicines help relieve peptic ulcer pain after a few weeks and promote ulcer healing. PPIs and H2 blockers work in different ways:
- PPIs suppress acid production by halting the mechanism that pumps acid into the stomach.
- H2 blockers work by blocking histamine, which stimulates acid secretion.
Although antibiotics can cure 80 to 90 percent of ulcers caused by H. pylori, eliminating the bacteria can be difficult. Patients must take all medicines exactly as prescribed, even when the peptic ulcer pain is gone.
At least 4 weeks after treatment, doctors test patients using a breath or stool test to be sure the H. pylori infection has been cured. Blood tests are not useful after treatment because a patient’s blood can test positive for H. pylori even after the bacteria have been eliminated.
If infection is still present, ulcers could recur or, less commonly, stomach cancer could develop. Thus, some patients need to take more than one round of medicines to kill the H. pylori bacteria.
Bismuth quadruple therapy is one of several treatments used after initial treatment has failed—a strategy called “rescue” or “salvage” therapy. In the second round of treatment, the doctor prescribes different antibiotics than those used in the first round.
Amoxicillin, however, can be used again to treat H. pylori infection because H. pylori resistance to this antibiotic is rare.
Can antacids or milk help a peptic ulcer heal?
An antacid may make the ulcer pain go away temporarily, but it will not kill H. pylori. People being treated for an H. pylori ulcer should check with their doctor before taking antacids. Some of the antibiotics used to kill H. pylori may not work as well if combined with an antacid.
People used to believe drinking milk helped peptic ulcers heal. But doctors know now that while milk may make an ulcer feel better briefly, it also increases stomach acid, which can make ulcers worse. Patients should talk with their doctor about drinking milk while an ulcer is healing.
Can H. pylori infection be prevented?
No one knows for sure how H. pylori spreads, so prevention is difficult. Researchers are trying to develop a vaccine to prevent—and even cure—H. pylori infection. To help prevent infection, doctors advise people to
- wash their hands with soap and water after using the bathroom and before eating
- eat food that has been washed well and cooked properly
- drink water from a clean, safe source
Points to Remember
- A peptic ulcer is a sore in the lining of the stomach or duodenum.
- Most peptic ulcers are caused by H. pylori. Use of NSAIDs—such as aspirin and ibuprofen—is another common cause.
- Neither stress nor spicy food causes ulcers. Smoking or drinking alcohol, however, each can worsen ulcers and prevent their healing.
- The abdominal discomfort of peptic ulcers
- feels a dull or burning pain
- occurs when the stomach is empty—between meals or during the night
- may be briefly relieved by eating food, in the case of duodenal ulcers, or by taking antacids, in both types of peptic ulcers
- lasts for minutes to hours
- comes and goes for several days or weeks
- A combination of antibiotics and acid-reducing medicines is the most effective treatment for H. pylori-induced peptic ulcers.
- Testing after treatment is needed to be sure the H. pylori infection is gone.
- To help prevent an H. pylori infection, people should
- wash their hands after using the bathroom and before eating
- eat properly prepared food
- drink water from a clean, safe source
source: National Digestive Diseases Information Clearinghouse (NDDIC)
Heliobacter Pylori Testing
As previously discussed in our Fall 2012 issue, Helicobacter pylori (H. pylori) is a bacteria found in the stomach that can cause a variety of intestinal disorders such as peptic ulcers and gastritis. This bacterium is also a very common cause for dyspepsia, a syndrome consisting of epigastric discomfort, feelings of early fullness after eating, and bloating.
For patients who do not have “alarm” symptoms such as weight loss or vomiting which require a more thorough evaluation, non-invasive testing for H. pylori can easily and effectively diagnose the presence of this bacterium. One such test that is commonly available now is a urea breath test.
This test can be used to both diagnose Helicobacter pylori and confirm its eradication. The test requires a patient to provide a sample of their breath about 20 minutes after ingesting a compound. This is the fact that H.
pylori can covert a compound called urea to both carbon dioxide and ammonia.
During this test, a patient will ingest a detectable type of carbon called an isotope. If H. pylori is present, this isotope will incorporate into carbon dioxide and will then be detectable in the patient’s breath.
There are two commercially available tests, and the only difference between these tests is the use of a radioactive isotope in one of the tests.
It should be noted that the amount of radiation used in the test is essentially equal to the normal radiation a person is exposed in their daily life.
The urea breath test has a reported sensitivity and specificity of 95%, meaning the chance of a false positive test is very low. False negative tests can also occur, especially if a patient is being prescribed certain medications.
The two classes of medications that can cause false negative results include antibiotics and proton pump inhibitors (PPIs) such as Nexium or Prilosec. These medications will suppress but not completely eliminate the presence of H. pylori in the stomach.
In order to eliminate this risk, a patient must not use antibiotics for four weeks and PPIs for two weeks prior to undergoing the test.
Another option in terms of non-invasive evaluation is the use of an H. pylori stool antigen test. The antigen is essentially a marker for the presence of active bacteria. This test offers a similar accuracy as compared to urea breath testing in detecting the bacteria.
However, it has a slightly higher chance of a false positive result in comparison to the urea breath test, and a similar chance of a false negative result. The main advantage of stool antigen testing is that it is slightly less costly as compared to the breath test.
The urea breath test is an increasingly common way for physicians to safely and accurately diagnose the presence of H. pylori in the most cost effective way possible. The increasing use of this test will undoubtedly lead to this bacterium to be more easily identified and thereby allow more and more patients to reap the benefits of treatment.
Tests for H. Pylori
Helicobacter pylori (H. pylori) is the bacterium (germ) responsible for most ulcers and many cases of stomach inflammation (chronic gastritis).
Peptic ulcer disease – H. pylori; PUD – H. pylori
How the test is performed
There are several different methods to test for H. pylori infection.
Breath test (called the carbon isotope-urea breath test or UBT):
- Up to 2 weeks before the test, the patient must stop taking any antibiotics, bismuth-containing medications such as Pepto-Bismol, and proton pump inhibitors (PPIs).
- The patient swallows a special substance containing urea (a waste product the body produces as it breaks down protein) that has been made harmlessly radioactive.
- If H. pylori are present, the bacteria convert the urea into carbon dioxide, which is detected and recorded in the patient's exhaled breath after 10 minutes.
- This test can identify almost all people who have H. pylori and confirm that the H. pylori infection has been fully treated.
- Blood tests are used to measure antibodies to H. pylori, and the results are reported in minutes.
- This test is not quite as accurate as the other tests.
- These blood tests can be used to diagnose whether an H. pylori infection is present. However, the test cannot determine whether you have an infection at the time of the test or how long you have had it because the test remains positive for years even if the infection is cured. As a result, it cannot be used to see if the infection has been eradicated.
- A test to detect the genetic traces of H. pylori in the feces appears to be as accurate as the breath test for initially detecting the bacteria, and for detecting recurrences after antibiotic therapy.
- This test can also be used to diagnose the infection and confirm that the H. pylori infection has been eradicated.
- The most accurate way to identify the presence of H. pylori is by taking a tissue biopsy from the lining of the stomach. The only way to do this is with endoscopy, which is an invasive but safe procedure.
- A biopsy will be done if endoscopy was needed for other reasons. This includes diagnosing the ulcer, treating any bleeding, or making sure cancer is not present. Otherwise, many patients are treated for H. pylori one of the three noninvasive tests listed above.
Why the test is performed
Testing is most often done to diagnose H. pylori infection:
- If you have a peptic ulcer currently
- If you had a peptic ulcer in the past and were never tested for H. pylori
- After treatment for H. pylori infection, to make sure the infection is fully treated and that the bacteria has gone away
Testing may also be done if you need to take long-term ibuprofen or other NSAIDs drugs. Ask your doctor.
Testing may also be done on some people with dyspepsia.
- Dyspepsia, or indigestion, is a feeling of fullness or of heat, burning, or pain in the area between the navel and the lower part of the breastbone during or after eating.
- Testing for H. pylori is most often done only when the indigestion is new, the person is younger than 55, and no other worrisome symptoms are present.
Normal results mean there is no sign that you have an H. pylori infection.
What abnormal results mean
Abnormal results mean that there is an infection of the stomach by H. pylori.
Ã¢ÂÂ¢ Patients who have H. pylori and also have an ulcer are most ly to benefit from being treated.
Ã¢ÂÂ¢ Patients who only have indigestion, heartburn, or acid reflux and H. pylori are less ly to benefit from treatment. The treatment does not work in all patients.
Ã¢ÂÂ¢ Patients who are taking long-term NSAID drugs may be treated for H. pylori, in order to prevent ulcers.
McColl KEL. Helicobacter pylori infection. NEJM. 2010;362(17):1597-1604.
Spee LA. Association between Helicobacter pylori and gastrointestinal symptoms in children. Pediatrics. 2010;125(3):e651-e669.
Review Date: 8/29/2011 12:00:00 AM
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Stool Test: H. Pylori Antigen
Helicobacter pylori (H. pylori) bacteria are a common cause of peptic ulcers (sores in the lining of the stomach, small intestine, or esophagus). In this test, a stool (feces) sample is used to determine if H. pylori antigens are present in your child's gastrointestinal (GI) system. Antigens are substances that trigger the immune system to fight infection.
Why It's Done
A doctor may request an H. pylori antigen stool test if your child has symptoms that could indicate the presence of a peptic ulcer, such as indigestion, abdominal pain, a full or bloated feeling, nausea, frequent belching, or vomiting. A test also might be ordered after your child completes a course of antibiotics for H. pylori to determine whether it eradicated the infection.
Un most other lab tests, a stool sample is often collected by parents at home, not by health care professionals at a hospital or clinic. For 2 weeks before the test, your child may be asked to avoid certain medications such as antibiotics, antacids, bismuth, and peptic ulcer medicines such as proton pump inhibitors (PPIs) and H2 blockers.
The doctor or hospital laboratory usually will provide written instructions on how to collect a stool sample. If instructions aren't provided, here are tips for collecting a stool sample from your child:
- Be sure to wear protective gloves and wash your hands and your child's hands afterward.
- Some young kids can't always let a parent know in advance when a bowel movement is coming. So a hat-shaped plastic lid is used to collect the stool specimen. This catching device can be quickly placed over a toilet bowl, or under your child's bottom, to collect the sample. Using a catching device can prevent contamination of the stool by water and dirt. Another way to collect a stool sample is to loosely place plastic wrap over the seat of the toilet. Then place the stool sample in a clean, sealable container before taking it to the lab.
- Plastic wrap can also be used to line the diaper of an infant or toddler who isn't yet using the toilet. The wrap should be placed so that urine runs into the diaper, not the wrap. Stools shouldn't be allowed to touch the inside of disposable diapers because the lining usually has antibacterial properties that can interfere with the test results.
- Your child shouldn't urinate into the container. If possible, have your child empty his or her bladder before a bowel movement.
- The stool should be collected into clean, dry plastic jars with screw-cap lids. Your child may be asked to provide a stool sample one or more times. For best results, the stool should be brought to the lab right away. If this isn't possible, the stool should be refrigerated and then taken to the lab as soon as possible.
Alternatively, a doctor or nurse may collect a small stool sample by inserting a swab into your child's rectum.
What to Expect
When the sample arrives at the laboratory, a small amount of stool is placed in tiny vials. Specific chemicals and a color developer are added. At the end of the test, the presence of a blue color indicates the presence of H. pylori antigens.
Getting the Results
In general, the result of the H. pylori stool test is reported in 1-4 days.
No risks are associated with collecting stool samples.
Helping Your Child
Collecting a stool sample is painless. Tell your child that collecting the stool won't hurt, but it has to be done carefully. A child who's old enough might be able to collect the sample alone to avoid embarrassment. Tell your child how to do this properly. If the sample is collected by swabbing, your child may feel slight pressure in his or her rectum during the procedure.
If You Have Questions
If you have questions about the H. pylori stool test, speak with your doctor.
H. pylori: Causes, Symptoms, Treatment
Helicobacter pylori (H. pylori) is a type of bacteria. These germs can enter your body and live in your digestive tract. After many years, they can cause sores, called ulcers, in the lining of your stomach or the upper part of your small intestine. For some people, an infection can lead to stomach cancer.
Infection with H. pylori is common. About two-thirds of the world’s population has it in their bodies. For most people, it doesn’t cause ulcers or any other symptoms. If you do have problems, there are medicines that can kill the germs and help sores heal.
As more of the world gets access to clean water and sanitation, fewer people than before are getting the bacteria. With good health habits, you can protect yourself and your children from H. pylori.
For decades, doctors thought people got ulcers from stress, spicy foods, smoking, or other lifestyle habits. But when scientists discovered H. pylori in 1982, they found that the germs were the cause of most stomach ulcers.
After H. pylori enters your body, it attacks the lining of your stomach, which usually protects you from the acid your body uses to digest food. Once the bacteria have done enough damage, acid can get through the lining, which leads to ulcers. These may bleed, cause infections, or keep food from moving through your digestive tract.
You can get H. pylori from food, water, or utensils. It’s more common in countries or communities that lack clean water or good sewage systems. You can also pick up the bacteria through contact with the saliva or other body fluids of infected people.
Many people get H. pylori during childhood, but adults can get it, too. The germs live in the body for years before symptoms start, but most people who have it will never get ulcers. Doctors aren’t sure why only some people get ulcers after an infection.
If you have an ulcer, you may feel a dull or burning pain in your belly. It may come and go, but you’ll probably feel it most when your stomach is empty, such as between meals or in the middle of the night. It can last for a few minutes or for hours. You may feel better after you eat, drink milk, or take an antacid.
Other signs of an ulcer include:
Ulcers can bleed into your stomach or intestines, which can be dangerous to your health. Get medical help right away if you have any of these symptoms:
It’s not common, but H. pylori infection can cause stomach cancer. The disease has few symptoms at first, such as heartburn. Over time, you may notice:
- Belly pain or swelling
- Not feeling hungry
- Feeling full after you eat just a small amount
- Weight loss for no reason
If you don’t have symptoms of an ulcer, your doctor probably won’t test you for H. pylori. But if you have them now or have in the past, it’s best to get tested. Medicines nonsteroidal anti-inflammatory drugs (NSAIDs) can also damage your stomach lining, so it’s important to find out what’s causing your symptoms so you can get the right treatment.
To start, your doctor will ask you about your medical history, your symptoms, and any medicines you take. Then she’ll give you a physical exam, including pressing on your belly to check for swelling, tenderness, or pain. You may also have:
- Tests of your blood and stool, which can help find an infection
- Urea breath test. You’ll drink a special liquid that has a substance called urea. Then you’ll breathe into a bag, which your doctor will send to a lab for testing. If you have H. pylori, the bacteria will change the urea in your body into carbon dioxide, and lab tests will show that your breath has higher than normal levels of the gas.
To look more closely at your ulcers, your doctor may use:
- Upper gastrointestinal endoscopy. In a hospital, a doctor will use a tube with a small camera, called an endoscope, to look down your throat and into your stomach and the upper part of your small intestine. The procedure may also be used to collect a sample that will be examined for the presence of the bacteria. You may be asleep or awake during the procedure, but you’ll get medicine to make you more comfortable.
- Upper GI tests. In a hospital, you’ll drink a liquid that has a substance called barium, and your doctor will give you an X-ray. The fluid coats your throat and stomach and makes them stand out clearly on the image.
- Computed tomography (CT) scan. It’s a powerful X-ray that makes detailed pictures of the inside of your body.
If you have H. pylori, your doctor may also test you for stomach cancer. This includes:
- Physical exam
- Blood tests to check for anemia, when your body doesn’t have enough red blood cells. It could happen if you have a tumor that bleeds.
- Fecal occult blood test, which checks your stool for blood that’s not visible to the naked eye
- Biopsy, when a doctor takes a small piece of tissue from your stomach to look for signs of cancer. Your doctor may do this during an endoscopy.
- Tests that make detailed pictures of the insides of your body, such as a CT scan or magnetic resonance imaging (MRI)
If you have ulcers caused by H. pylori, you’ll need treatment to kill the germs, heal your stomach lining, and keep the sores from coming back. It usually takes 1 to 2 weeks of treatment to get better.
Your doctor will probably tell you to take a few different types of drugs. The options include:
- Antibiotics to kill the bacteria in your body, such as amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl), tetracycline (Sumycin), or tinidazole (Tindamax). You’ll most ly take at least two from this group.
- Drugs that reduce the amount of acid in your stomach by blocking the tiny pumps that produce it. They include dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex).
- Bismuth subsalicylate, which may also help kill H. pylori along with your antibiotics
- Medicines that block the chemical histamine, which prompts your stomach to make more acid. These are cimetidine (Tagamet), famotidine (Fluxid, Pepcid), nizatidine (Axid), or ranitidine (Zantac).
Your treatment could mean you’ll take 14 or more pills per day for a few weeks, which seems a lot of medicine. But it’s really important to take everything that your doctor prescribes and to follow her instructions.
If you don’t take antibiotics the right way, bacteria in your body can become resistant to them, which makes infections harder to treat.
If your medications bother you, talk to your doctor about your treatment options and how you can handle side effects.
About 1-2 weeks after you finish your treatment, your doctor may test your breath or stool again to make sure the infection is gone.
You can protect yourself from getting an H. pylori infection with the same steps you take to keep other germs at bay:
- Wash your hands after you use the bathroom and before you prepare or eat food. Teach your children to do the same.
- Avoid food or water that’s not clean.
- Don’t eat anything that isn’t cooked thoroughly.
- Avoid food served by people who haven’t washed their hands.
Though stress, spicy foods, alcohol, and smoking don’t cause ulcers, they can keep them from healing quickly or make your pain worse. Talk to your doctor about ways to manage your stress, improve your diet, and, if you smoke, how you can get help to quit.
Most ulcers caused by H. pylori will heal after a few weeks of treatment. If you’ve had one, you should avoid taking NSAIDs for pain, since these drugs can damage your stomach lining. If you need pain medicine, ask your doctor to recommend some.
You can find information about H. pylori infection and ulcers from the American College of Gastroenterology. For information on stomach cancer, as well as online and local support groups, visit the American Cancer Society.
National Digestive Diseases Information Clearinghouse: “Peptic Ulcer Disease and H. Pylori.”
National Cancer Institute: “Helicobacter pylori and Cancer.”
KidsHealth: “Infections: Helicobacter Pylori.”
National Institute of Diabetes and Digestive and Kidney Diseases: “The Burden of Digestive Diseases: Peptic Ulcer Disease.”
American College of Gastroenterology: “Peptic Ulcer Disease.”
UpToDate. “Helicobacter pylori infection and treatment.”
American Cancer Society: “How is stomach cancer diagnosed?” “How is stomach cancer treated?” and “Signs and symptoms of stomach cancer.”
© 2018 WebMD, LLC. All rights reserved.
Helicobacter pylori (H. pylori) bacteria are a common cause of digestive illnesses, including gastritis (the irritation and inflammation of the stomach lining), peptic ulcers (sores in the lining of the stomach, small intestine, or esophagus), and even stomach cancer later in life.
These bacteria are found worldwide, but especially in developing countries, where up to 10% of children and 80% of adults are ly to have had an H. pylori infection — usually without any symptoms.
Signs and Symptoms
Anyone can have an H. pylori infection without knowing it — most H. pylori infections are “silent” and cause no symptoms. When the bacteria do cause symptoms, they're usually either symptoms of gastritis or peptic ulcer disease.
In kids, symptoms of gastritis may include nausea, vomiting, and abdominal pain, although these symptoms are seen in many childhood illnesses.
H. pylori, which used to be called Campylobacter pylori, also can cause peptic ulcers (commonly known as stomach ulcers).
In older kids and adults, the most common symptom of peptic ulcer disease is a gnawing or burning pain in the abdomen, usually in the area below the ribs and above the navel.
This pain often gets worse on an empty stomach and improves as soon as the person eats food, drinks milk, or takes antacid medicine.
Kids who have peptic ulcer disease can have ulcers that bleed, causing hematemesis (bloody vomit or vomit that looks coffee grounds) or melena (stool that's black, bloody, or looks tar). Younger children with peptic ulcers may not have such clear symptoms, so their illness may be harder to diagnose.
Scientists suspect that H. pylori infection may be contagious because the infection seems to run in families and is more common where people live in crowded or unsanitary conditions. Although research suggests that infection is passed from person to person, exactly how this happens isn't really known.
Doctors can make the diagnosis of an H. pylori infection by using many different types of tests. A doctor may:
- look at the stomach lining directly. The patient will be under sedation during this procedure, which involves inserting an endoscope — a small, flexible tube with a tiny camera on the end — down the throat and into the stomach and duodenum. The doctor may then take samples of the lining to be checked in the laboratory for microscopic signs of infection and for H. pylori bacteria.
- do blood tests, which can detect the presence of H. pylori antibodies. Blood tests are easy to do, although a positive test may indicate exposure to H. pylori in the past, not an active infection.
- do breath tests, which can detect carbon broken down by H. pylori after the patient drinks a solution. Breath tests are time-consuming, provide no information about the infection's severity, and can be difficult to perform in young children.
- do stool tests, which can detect the presence of H. pylori proteins in the stool (poop). breath testing, stool tests indicate the presence of H. pylori but give no information about an infection's severity.
Doctors treat H. pylori infections using antibiotics. Because a single antibiotic may not kill the bacteria, your child will normally be given a combination of antibiotics. Usually, the doctor will also give antacids or acid-suppressing drugs to neutralize or block production of stomach acids.
If your child has symptoms of bleeding from the stomach or small intestine, these symptoms will be treated in a hospital.
Because H. pylori infection can be cured with antibiotics, the most important home treatment is to give your child any prescribed antibiotic medicine on schedule for as long as the doctor has directed.
One way to help soothe the abdominal pain is by following a regular meal schedule. This means planning meals so that your child's stomach doesn't remain empty for long periods. Eating five or six smaller meals each day may be best, and your child should take some time to rest after each meal.
It's also important to avoid giving your child aspirin, aspirin-containing medicines, ibuprofen, or anti-inflammatory drugs because these may irritate the stomach or cause stomach bleeding.
With prolonged antibiotic therapy, H. pylori gastritis and peptic ulcer disease (especially ulcers in the duodenum, a portion of the small intestine) often can be cured.
Right now, there's no vaccine against H. pylori. And because transmission isn't clearly understood, prevention guidelines aren't available. However, it's always important to make sure you and your family:
When to Call the Doctor
Call your doctor immediately if your child has any of these symptoms:
- severe abdominal pain
- vomit that's bloody or looks coffee grounds
- stool that's bloody, black, or looks tar
- lasting gnawing or burning pain in the area below the ribs that improves after eating, drinking milk, or taking antacids
However, it's important to remember kids can get stomachaches for many reasons — indigestion, viruses, tension and worry, and appendicitis. Most stomachaches are not caused by H. pylori bacteria.
Helicobacter Pylori (H. Pylori) Tests: MedlinePlus Lab Test Information
URL of this page: https://medlineplus.gov/lab-tests/helicobacter-pylori-h-pylori-tests/
Helicobacter pylori (H. pylori) is a type of bacteria that infects the digestive system. Many people with H.
pylori will never have symptoms of infection. But for others, the bacteria can cause a variety of digestive disorders.
These include gastritis (inflammation of the stomach), peptic ulcers (sores in the stomach, small intestine, or esophagus), and certain types of stomach cancer.
There are different ways to test for an H. pylori infection. They include blood, stool, and breath tests. If you are having digestive symptoms, testing and treatment may help prevent serious complications.
Other names: H. pylori stool antigen, H. pylori breath tests, urea breath test, rapid urease test (RUT) for H. pylori, H. pylori culture
H. pylori tests are most often used to:
- Look for H. pylori bacteria in the digestive tract
- Find out if your digestive symptoms are caused by an H. pylori infection
- Find out if treatment for an H. pylori infection has worked
You may need testing if you have symptoms of a digestive disorder. Since gastritis and ulcers both inflame the lining of the stomach, they share many of the same symptoms. They include:
An ulcer is a more serious condition than gastritis, and symptoms are often more severe. Treating gastritis in early stages may help prevent the development of an ulcer or other complications.
There are different ways to test for H. pylori. Your health care provider may order one or more of the following types of tests.
- Checks for antibodies (infection-fighting cells) to H. pylori
- Test procedure:
- A health care professional will take a blood sample from a vein in your arm, using a small needle.
- After the needle is inserted, a small amount of blood will be collected into a test tube or vial.
Breath test, also known as a urea breath test
- Checks for infection by measuring certain substances in your breath
- Test procedure:
- You will provide a sample of your breath by breathing into a collection bag.
- After that, you will swallow a pill or liquid containing a harmless radioactive material.
- You will provide another sample of your breath.
- Your provider will compare the two samples. If the second sample has higher than normal carbon dioxide levels, it is a sign of an H. pylori infection.
Stool tests.Your provider may order a stool antigen or a stool culture test.
- A stool antigen test looks for antigens to H. pylori in your stool. Antigens are substances that trigger an immune response.
- A stool culture test looks for H. pylori bacteria in the stool.
- Samples for both types of stool tests are collected in the same way. Sample collection usually includes the following steps:
- Put on a pair of rubber or latex gloves.
- Collect and store the stool in a special container given to you by your health care provider or a lab.
- If collecting a sample from a baby, line the baby's diaper with plastic wrap.
- Make sure no urine, toilet water, or toilet paper mixes in with the sample.
- Seal and label the container.
- Remove the gloves, and wash your hands.
- Return the container to your health care provider.
Endoscopy. If other tests did not provide enough information for a diagnosis, your provider may order a procedure called an endoscopy. An endoscopy allows your provider to look at your esophagus (the tube that links your mouth and stomach), the lining of your stomach, and part of your small intestine. During the procedure:
- You will lie down on an operating table on your back or side.
- You will be given medicine to help you relax and prevent you from feeling pain during the procedure.
- Your provider will insert a thin tube, called an endoscope, into your mouth and throat. The endoscope has a light and camera on it. This allows the provider to get a good view of your internal organs.
- Your provider may take a biopsy (removal of a small sample of tissue) to examine after the procedure.
- After the procedure, you will be observed for an hour or two while the medicine wears off.
- You may be drowsy for a while, so plan to have someone drive you home.
- You don't need any special preparation for an H. pylori blood test.
- For breath, stool, and endoscopy tests, you may need to stop taking certain medicines for as long as two weeks to a month before testing. Be sure to talk with your health care provider about all medicines you are currently taking.
- For an endoscopy, you may need to fast (not eat or drink) for about 12 hours before the procedure.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There is no known risk to having breath or stool tests.
During an endoscopy, you may feel some discomfort when the endoscope is inserted, but serious complications are rare. There is a very small risk of getting a tear in your intestine. If you had a biopsy, there is a small risk of bleeding at the site. Bleeding usually stops without treatment.
If your results were negative, it means you probably don't have an H. pylori infection. Your provider may order more tests to find out the cause of your symptoms.
If your results were positive, it means you have an H. pylori infection. H. pylori infections are treatable. Your health care provider will probably prescribe a combination of antibiotics and other medicines to treat the infection and relieve pain.
The medicine plan can be complicated, but it's important to take all the medicines as prescribed, even if your symptoms go away. If any H. pylori bacteria remain in your system, your condition can worsen. Gastritis caused by H.
pylori can lead to a peptic ulcer and sometimes stomach cancer.
After you've been treated with antibiotics, your health care provider may order repeat tests to make sure all the H. pylori bacteria is gone.