H. Pylori Infection – Diagnosis and Treatment
Diagnosis
Stool Sample Checks
Stool detection methods make it easy to check for Helicobacter pylori infection. The stool antigen test is the most common—this test spots certain proteins from H. pylori in your stool.
If those proteins show up, you’ve got an infection. Another option, the stool PCR analysis, checks for H. pylori genes and can even catch changes in the bacteria that might make antibiotics less effective.
PCR analysis is super helpful, but honestly, it can be pricey and isn’t available everywhere.
Here’s a quick comparison of the two main stool tests:
| Test Type | Finds H. pylori? | Detects Resistance? | Cost | Common Availability |
|---|---|---|---|---|
| Stool Antigen | Yes | No | Lower | Wide |
| Stool PCR | Yes | Yes | Higher | Limited |
Breath-Based Detection
The urea breath test is another popular way to spot H. pylori in your stomach. The process is pretty simple.
You swallow something with special carbon molecules. If H. pylori is hanging around, it will break down the solution and release carbon, which you then breathe out.
A device measures the carbon in your breath. This works for adults and kids old enough to follow directions (usually age six and up). People like this test because it doesn’t involve needles or sticking a tube down your throat.
Steps in a Urea Breath Exam
- Swallow the pill or liquid.
- Wait a bit and breathe out into a special bag.
- A technician measures the carbon in your breath.
- You get results about H. pylori infection.
Viewing the Digestive Tract
Sometimes, a doctor needs to look inside your stomach and the upper part of your intestines. They use a scope for this, called an upper endoscopy.
You’ll get medicine to help you relax, and then the doctor guides a thin, flexible tube with a camera down your throat.
With the scope, doctors can spot swelling, ulcers, or other issues. They can also grab tiny pieces of tissue (biopsies) to test directly for H. pylori, using methods like the rapid urease test or lab staining.
This method gives a lot more detail and helps guide treatment, especially if other tests don’t give clear answers or if treatment hasn’t worked so far.
When is endoscopy with biopsy most useful?
- When symptoms are unusual or severe
- If doctors suspect ulcers, bleeding, or tumors
- When first treatments don’t work and a new approach is needed
Things to Keep in Mind Before Testing
A few things can mess with H. pylori test results. Some medicines, like antibiotics, make it hard to get the right answer. Doctors usually tell you to stop these drugs for at least four weeks before any H. pylori test.
Other meds, like proton pump inhibitors (PPIs) and bismuth subsalicylate, can also interfere. Even H-2 blockers might affect the results. Doctors often suggest stopping these drugs up to two weeks before testing.
Key points for accurate results:
- Wait at least four weeks after antibiotics before retesting.
- Stop PPIs and bismuth for two weeks if you can.
- Always follow your health care provider’s instructions.
Doctors use the same stool, breath, or biopsy tests to check if H. pylori is gone after treatment. Following these rules helps make sure results are reliable and future care is based on good information.
Treatment
Doctors fight H. pylori mainly with eradication therapy. This usually involves taking at least two prescription antibiotics, such as a macrolide, a beta-lactam, a nitroimidazole, or a tetracycline-class drug.
hese antibiotics work by targeting the bacteria in different ways. They may stop its growth, damage its cell wall, or interfere with its ability to reproduce. This combined approach helps clear the infection more effectively.
Using more than one antibiotic lowers the chance of resistance, especially to macrolides.
A proton pump inhibitor (PPI) usually joins in. PPIs cut down stomach acid and help the meds work better. Sometimes, bismuth subsalicylate gets added to protect the stomach lining and speed up healing.
Common treatment types:
| Therapy | What It Includes |
|---|---|
| Triple Therapy | 2 antibiotics + 1 PPI |
| Bismuth Quadruple Therapy | 2 antibiotics + bismuth + 1 PPI |
| Fluoroquinolone Triple | A fluoroquinolone-class antibiotic + other antibiotics + PPI |
If first-line therapy doesn’t work, doctors might use hybrid, concomitant, or sequential therapy. Sometimes, probiotics help with antibiotic side effects.
After finishing treatment, doctors recommend a test of cure at least four weeks later to make sure the bacteria are gone. If it’s still there, they’ll try different meds or adjust the plan.
Getting Ready for Your Visit
Getting organized before seeing your health care provider really helps, especially if you’re dealing with H. pylori issues like belly pain, unexplained weight loss, iron deficiency anemia, or ongoing nausea.
Write down all your symptoms, including any loss of appetite or severe vomiting. Note if these symptoms stick around or come and go.
Make a list of any meds or supplements you’re taking, especially NSAIDs like aspirin, ibuprofen, or naproxen sodium. Since these can add to stomach problems, sharing this early helps your provider suggest safe treatments.
Before your appointment, check with the clinic to see if you need to do anything special, like avoid certain foods or stop some medicines.
Here’s a quick table:
| Task | Details |
|---|---|
| Bring symptom details | Note when they began, and how bad they feel |
| Medication list | Include prescription, over-the-counter, and NSAIDs |
| Ask about prep | Some tests need changes in diet or medicine |
| Doctor’s instructions | Follow any special guidance from clinic/office |
Jot down questions you want to ask. A few ideas:
- How did the infection cause my health problems?
- What tests will I need, and how should I get ready?
- Are there treatments that fit my needs based on current guidelines?
- How will we know if the treatment worked?
If something else pops up, add it to your list.
Questions Your Provider May Ask
When you visit, your healthcare provider will ask questions to get a clear picture and pick the right tests or treatments.
They might ask:
- When did your symptoms, like belly pain or nausea, start?
- How strong or frequent is the discomfort? Any severe vomiting or big weight changes?
- Have things improved or gotten worse with certain foods, activities, or medicines like NSAIDs?
- Does anyone in your family have similar problems, like dyspepsia or chronic infection?
- Are you regularly taking over-the-counter pain meds, such as ibuprofen or naproxen sodium?
Your provider may also talk about risk factors that can make H. pylori infections or their complications worse—like family history, NSAID use, or existing conditions such as iron deficiency anemia.
When you bring the right info and stay open with your provider, you spend more time planning treatment and less time going over basics. That way, you tackle not just the infection but any risks or complications, giving yourself the best shot at recovery.
