Four Methods for Detecting H. pylori Bacteria Infections

Testing for H. pylori (Helicobacter pylori) bacteria becomes necessary when patients exhibit persistent symptoms of peptic ulcers or experience an unusually severe progression of the condition. Additionally, H. pylori testing is repeated after treatment to determine if the patient has been effectively cured. The decision to use specific H. pylori testing methods depends on several factors, as outlined below:

1. When is H. pylori Testing Necessary?

Medical practitioners determine the need for H. pylori testing based on the following factors:

• Availability of testing facilities: The availability of tests for H. pylori and their compliance with performance standards at the healthcare facility.
• Urgency of testing: In cases where the symptoms are not acute, and waiting for test results won't significantly impact the patient's health, slower tests such as bacterial culture may be chosen.
• Additional requirements: Does the patient require assessment for stomach damage, or is an antibiotic resistance test necessary?

Based on these considerations, the healthcare provider will choose one or a combination of the following H. pylori tests.

2. Endoscopy for Detecting H. pylori in the Stomach

In this method, a small endoscope equipped with a camera is inserted into the stomach via the esophagus to locate the ulcer. A biopsy is taken from the area around the ulcer to perform a Urea Breath Test or bacterial culture, or simply to assess the ulcer's morphology, which allows for a preliminary diagnosis of the patient's H. pylori infection. Endoscopy not only provides an accurate diagnosis of stomach and duodenal ulcers but also helps in assessing the severity of symptoms, the location of damage, and selecting the most appropriate treatment plan. Although some patients may find endoscopy uncomfortable, especially the elderly, it is essential for evaluating stomach damage that other tests cannot achieve. If a patient has been treated for H. pylori, and symptoms persist, an antibiogram may be conducted to determine antibiotic resistance and select an alternative treatment.

3. Urea Breath Test (Breath Test) for H. pylori

The Urea Breath Test is a non-invasive method widely used in many countries, to detect H. pylori. Patients exhale into a specialized device, which comes in two forms:

• Balloon breath test: Patients exhale into a balloon-like device.
• Card breath test: Patients exhale into a card-like device similar to an ATM card.

The patient's breath is then analyzed using specialized equipment, providing indicators for the doctor to evaluate whether the patient tests positive for H. pylori. The Urea Breath Test delivers accurate results quickly, without the need for invasive procedures, and is suitable for individuals of all ages. It is especially valuable for re-evaluating the effectiveness of H. pylori treatment.

4. Stool Test for H. pylori

When H. pylori bacteria are present in the stomach, they are regularly excreted through feces. Stool testing for H. pylori, which employs immunofluorescence, offers an accurate method for detecting the bacteria. This test is particularly preferred for evaluating H. pylori infections that cause duodenal ulcers. While the process is relatively straightforward for patients, results may not be immediate, which can be somewhat inconvenient. Stool testing can also pose hygiene and convenience challenges for both patients and technicians.

5. Blood Test for H. pylori Detection

In H. pylori infections, the body produces anti-H. pylori antibodies, which are present in the blood and can be detected through blood tests. Blood tests for H. pylori are widely available in most provincial and city-level healthcare facilities across the country. However, this is not the preferred test method because it has a relatively high risk of false positives.

H. pylori bacteria can exist in other areas, leading to positive blood test results in locations such as the oral cavity, sinuses, and intestines without causing disease. Furthermore, anti-H. pylori antibodies may persist in the blood for months or even years after the bacteria in the stomach have been eradicated, making this test less reliable. Blood tests for H. pylori are typically used when no other testing methods are available.

Each type of test has its own set of advantages and drawbacks, and the choice of test is determined by the healthcare provider after an evaluation of the patient's specific needs.