How to Test for Helicobacter Pylori Infection

There are several methods available for detecting a Helicobacter pylori (H. pylori) infection, which can generally be categorized into two main types: invasive and non-invasive testing. Each method has its own advantages and is selected based on the patient's condition and medical recommendations.

Invasive Testing

Invasive procedures typically occur during an endoscopy. During this process, a small tissue sample (biopsy) is taken from the stomach lining. One common method is the rapid urease test, which detects the presence of H. pylori by identifying the bacteria's ability to produce urease. Additionally, another biopsy sample may be sent to a pathology lab for special staining to visualize the bacteria under a microscope. Culturing the bacteria from a biopsy sample is also possible, and if H. pylori grows in the culture, it confirms an active infection.

Non-Invasive Testing

Among non-invasive methods, the carbon-13 breath test is widely used due to its high accuracy and safety. This test involves drinking a solution containing carbon-13 labeled urea. If H. pylori is present in the stomach, it breaks down the urea, and the labeled carbon can be detected in the patient's breath. Another option is the stool antigen test, which detects H. pylori proteins in fecal samples, offering a reliable and easy-to-administer alternative.

Blood tests that detect H. pylori antibodies are also available but are considered less precise. These tests can indicate past exposure to the bacteria, even if the infection has been successfully treated. Therefore, they are more commonly used in epidemiological studies rather than for diagnosing active infections in individual patients.

Overall, the carbon-13 breath test remains the most popular and safest choice in clinical practice due to its minimal invasiveness, quick results, and low risk to the patient.