Helicobacter pylori test: when to take it and which method to choose

What is Helicobacter pylori and why is it dangerous?

Helicobacter pylori is a spiral-shaped bacterium that colonizes the lining of the stomach. In 70% cases, it does not cause symptoms, but it can cause:

• gastritis and erosions

• stomach and duodenal ulcer

• bad breath

• bloating, upper abdominal pain

• in the long term — risk of stomach cancer

Therefore, timely detection of Helicobacter pylori is one of the key steps in prevention gastrointestinal diseases.

Main indications for testing

• intermittent abdominal pain

• nausea, heartburn, belching

• diagnosis of “gastritis” or “ulcer”

• anemia of unknown origin

• decreased appetite, weight loss

• family history of gastric cancer

• control after treatment of Helicobacter infection

What are the tests for Helicobacter pylori?

There are several types of tests — each has its pros and cons. They are prescribed depending on the situation.

Serological analysis (IgG, IgA)

• What does it reveal?: antibodies to H. pylori in the blood

• Pros: fast, inexpensive, accessible

• Cons: does not distinguish between active and past infection

• When appropriate: for initial examination

Urea breath test (13C or 14C)

• What does it reveal?: active presence of bacteria due to cleavage of labeled urea

• Pros: non-invasive, highly accurate, results in an hour

• Cons: more expensive, requires preparation

• When appropriate: post-treatment control, diagnosis clarification

Antigen in feces

• What does it reveal?: presence of bacterial proteins in feces

• Pros: high accuracy, suitable for children

• Cons: cannot be taken after antibiotics or PPIs

• When appropriate: screening, treatment monitoring

Biopsy during gastroscopy (histology, PCR, urease test)

• What does it reveal?: bacteria directly in the stomach mucosa

• Pros: the gold standard for complex cases

• Cons: invasive, requires anesthesia

• When appropriate: for ulcers, complicated gastritis, ineffective therapy

How to choose the right method

How to prepare for the analysis

• In 2–4 weeks — do not take antibiotics, bismuth preparations, PPIs (omeprazole, pantoprazole)

• In 1 day — do not drink alcohol, coffee is prohibited

• For the breath test — on an empty stomach, do not smoke, do not chew gum in the morning

• For feces — do not use suppositories, enemas, or sorbents before delivery

Proper preparation is the key to an accurate result.

Even asymptomatic Helicobacter pylori infection can damage the stomach lining for years. If your doctor recommends testing, don't delay. Early detection of the bacteria allows you to undergo a short course of treatment and avoid chronic problems with the gastrointestinal tract.