What Does a Positive H. pylori Test Result Mean?

A positive Helicobacter pylori (H. pylori) result typically comes from diagnostic tests such as the carbon-13 or carbon-14 breath test, urease test on gastric biopsy tissue, or bacterial culture of gastric mucosa. This bacterium is one of the most common causes of chronic gastritis, peptic ulcers, duodenal ulcers, gastric lymphoma, and even stomach cancer.

For individuals diagnosed with any of these gastrointestinal conditions, a confirmed positive H. pylori result usually indicates the need for eradication therapy. This treatment often involves a combination of antibiotics and acid-reducing medications to eliminate the infection and promote healing of the stomach lining.

However, if a patient undergoes endoscopy and shows no signs of gastric disease or experiences no symptoms, aggressive treatment may not be necessary. In such cases, doctors generally recommend regular monitoring rather than immediate intervention.

It's also important to note that a blood test showing positive antibodies against H. pylori does not always confirm an active infection. Antibodies can remain in the bloodstream for years after a past infection has resolved. Therefore, a positive antibody result alone cannot determine whether the infection is current or historical, making it an unreliable indicator for starting eradication therapy.

In situations where only serological testing (blood antibody test) is available and there's uncertainty about active infection, it is strongly recommended to follow up with a carbon-13 or carbon-14 breath test. These non-invasive and highly accurate methods can help confirm whether an active H. pylori infection is present, guiding further clinical decisions.