Helicobacter Pylori Test - Indications, Essence, Preparation, Decoding, How Is It Carried Out?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Helicobacter pylori test: types of tests and decoding

Timely detection and destruction of bacteria such as Helicobacter pylori in modern medicine is considered as a priority in terms of preventing serious diseases of the digestive system (stomach cancer and stomach ulcer). The complexity of diagnosis lies in the fact that in many regions of the country, non-invasive techniques that allow establishing the fact of infection are simply not available to the population. While treatment without a laboratory-confirmed diagnosis is prescribed everywhere. This entails an unreasonable selection of antibiotic therapy and the growth of bacterial resistance to it. Therefore, it is a high-quality check for Helicobacter pylori that is so important, which makes it possible to establish the fact of the presence of bacteria in the human stomach.

The Helicobacter pylori breath test is a non-invasive technique for detecting infection in a person's exhaled air. Research is carried out using a specialized breathing test system. It is used for the primary detection of bacteria, for monitoring treatment and assessing the degree of its effectiveness.

In general, the study boils down to drawing air that a person exhales into a test tube or tube. Fences are made before and after loading the loading solution. Then the diagnostician evaluates the results, determines the degree of infection with the bacterium based on its urease activity. Therefore, this type of study is also called urease breath test.

Content:

• Indications for passing the Helicobacter pylori test
• The essence of the respiratory urease test for Helicobacter pylori
• Preparation for the procedure
• How is the urease breath test performed with carbon isotope labeled urea?
• How is the 13C-urease breath test performed?
• How is the Helicobacter pylori test performed?
• Decoding the results of a breath test for Helicobacter pylori
• What if the test is positive?
• Rapid tests for Helicobacter pylori

Indications for passing the Helicobacter pylori test

The bacterium Helicobacter pylori is a gram-negative, spiral-shaped pathogen that colonizes the antrum of the stomach and intestines. The waste products of bacteria lead to the fact that the mucous membrane of these organs of the digestive system will become inflamed, ulcers and erosion will appear on it. In the future, if left untreated, this will lead to the development of diseases such as gastritis, stomach ulcers and even stomach cancer. For the discovery of this bacterium, two scientists (Robin Warren and Barry Marshall) received the Nobel Prize.

Helicobacter pylori can be transmitted from one person to another when kissing or when using common household items. Therefore, for the first time, the bacterium enters the body, most often in childhood. The acidic environment of the stomach is not able to destroy the microorganism, since it has its own defense mechanisms against it.

Sometimes the disease begins its development immediately after the infection has occurred, and sometimes after a certain time interval. Often the bacterium can exist absolutely asymptomatically in the body for several years and shows its activity only as a result of a combination of certain factors, for example, after suffering stress or against the background of a sharp decrease in immunity.

A test for the presence of Helicobacter pylori must be done to those people who have symptoms of disorders in the functioning of the digestive system, among them:

• Frequent belching.
• Heartburn with separation of acidic contents.
• Hiccups.
• Bad breath against the background of the health of the oral cavity itself.
• Stomach pain, discomfort.
• Stool disorder, while diarrhea can be replaced by constipation.
• Symptoms indicating a malfunction in metabolic processes: hair loss, dry skin, increased fragility of nails.
• Fast saturation with small portions of food, disturbances in its digestion.
• Intolerance to meat dishes.

If a person has any of the above signs, a test for Helicobacter pylori should be prescribed. Also, all family members should be examined, provided that one of them was found to have this bacterium.

The essence of the respiratory urease test for Helicobacter pylori

The breath test is based on the ability of bacteria to secrete a special enzyme called urease. It is necessary for Helicobacter pylori so that human gastric juice does not destroy its membrane.

In the stomach, urease breaks down urea into ammonia and carbon dioxide. Gas is released into the external environment. This is what the analyzer catches.

There are several varieties of the urease breath test for Helicobacter pylori, including:

• Respiratory urease test using isotopically labeled urea. In this case, the subject during the procedure drinks a solution of urea, which was previously labeled with isotopes.

• 13C-urease breath test. In this case, urea labeled with stable non-radioactive isotope C13 acts as a loading solution.
• Helik test. When carrying out the helik test, not urea is used, but a urea solution.

Regardless of what kind of research is performed on the patient, they all have a high degree of accuracy.

Preparation for the procedure

Before passing the test for Helicobacter pylori, the patient must carry out a number of preparatory measures.

• A study is prescribed no earlier than 3-6 days after taking antibiotics or antisecretory drugs. Also, 5 days before the procedure, you should exclude the intake of painkillers, antacids and NSAIDs. If a person takes any medications on an ongoing basis, then he should consult a doctor about this to clarify the possibility of the procedure.
• At least 3 days before the study, it will be necessary to exclude the intake of alcoholic beverages.
• The day before the procedure, you should not eat foods that increase gas formation. It is recommended to remove potatoes, bakery and pastry products, cabbage, peas and beans from the menu.
• On the evening before the study, you should eat light foods. The meal should take place 2-3 hours before bedtime.
• At least 6 hours should elapse between the study and the last meal. The procedure is performed on an empty stomach.
• It is forbidden to eat in the morning, you should refrain from using chewing gum.
• You cannot smoke before the procedure. You need to give up tobacco 3-4 hours before the procedure.

• Brush your teeth and rinse your mouth before taking the test.
• You can drink water for the last time an hour before the study, but its volume should not exceed 100 ml.

If you follow all the suggested recommendations, the test result will be as reliable as possible.

How is the urease breath test performed with carbon isotope labeled urea?

The procedure begins with the patient being asked to breathe through the tube. It is located deep in his mouth, the mouth cavity itself will be slightly open. You need to breathe calmly and smoothly. At this time, the doctor takes two air samples.

Then the patient is offered to drink isotope-labeled urea solution. After 15 minutes, 4 more air samples are taken. Care should be taken to ensure that the subject's saliva does not enter the tube. To do this, he can take it out from time to time and smooth out the accumulated liquid. If it happened that saliva still got inside the sample, then the test should be stopped and repeated after an hour. Although modern devices make it possible to protect air samples from saliva entering them.

How is the 13C-urease breath test performed?

It is the 13C-urease test that is the most frequently used test for the detection of Helicobacter pylori. During the procedure, only two air samples are taken from the subject.

The first sample is taken in the morning on an empty stomach, and the second sample is taken half an hour after ingestion of the urea solution labeled with the stable isotope C13. A person exhales air in disposable bags that are specially designed for this procedure.

This type of research has several advantages, including:

• The diagnostic accuracy is high, reaching 100%.
• The procedure is safe for health, as it does not use radioactive substances.
• The research does not take long. In general, it takes 40 minutes to complete.

How is the Helicobacter pylori test carried out?

Helic-test is carried out according to the same scheme as the 13C-urease breath test. The only difference is that instead of isotopically labeled urea, a person receives a solution of urea. Air intake is carried out by 2 samples: before taking the solution and after taking it.

The undoubted advantage of the study is its complete safety for human health. This is the best test for detecting H. pylori in pregnant women and children. However, a number of experts question the accuracy of the results obtained. Therefore, the helik test is carried out only in Russia.

Decoding the results of a breath test for Helicobacter pylori

A breath test can give two results: positive or negative. The patient either has Helicobacter pylori in the body, or there was no infection.

Also, using a special device called a mass spectrometer, the quantitative values of Helicobacter pylori in the body are determined.

The data obtained can be interpreted as follows:

• If the stabilized isotope in the exhaled air contains from 1 to 3.4%, then the degree of infection is mild.
• With an isotope concentration in the range of 3.5-6.4%, one speaks of an average degree of infection.
• A severe infection with Helicobacter pylori will be indicated by indicators of 6.5-9.4%.
• The extremely severe degree is indicated by values of more than 9.5%.

As a rule, the accuracy of the test is not in doubt. It is possible to obtain a negative result only if the conditions of preparation for the study are not observed. Some drugs can reduce the activity of gastric acid production, which will lead to the inability to break down urea.

Test results can be found 1-2 days after the study. The shelf life of the collected samples is 10 days, but no more.

What if the test is positive?

If the test for Helicobacter pylori is positive, then the patient will need to undergo a comprehensive examination of the digestive system. The patient must be referred to EGDS, which will provide information about the state of the stomach and duodenum. He will also donate blood for biochemical and general analysis; other studies may be required.

Helicobacter pylori requires treatment. Depending on the severity and nature of the lesion of the inner wall of the stomach, a therapeutic scheme is selected. However, antibiotics are always used to eliminate bacteria, which are combined with proton pump inhibitors. In this case, two antibacterial drugs will be prescribed. It can be Amoxicillin, Levofloxacin, Metronidazole, Clarithromycin, etc.

During the course of treatment or after its completion, the doctor may offer the patient another test for Helicobacter pylori. This is required to monitor the effectiveness of the therapy or to evaluate the treatment already carried out. The gastroenterologist deals with the treatment of diseases of the digestive system.

Rapid tests for Helicobacter pylori

To determine the presence of pathogenic flora, there is no need to go to the laboratory. You can buy rapid tests that are intended for home use at the pharmacy. With their correct application, the reliability of the results reaches 100%.

There are two types of rapid tests, the biological material for which is blood or feces.

To perform a test for the detection of Helicobacter pylori in blood at home, you will need to observe the following algorithm of actions:

• Wash your hands thoroughly, treat them with an antiseptic solution.
• Remove all components of the dough from the packaging, place them on a clean and dry surface.
• Treat your finger with an injection wipe.
• Open the scarifier that comes with the test and make a small puncture on your finger so that blood flows out of it.
• By pressing on your finger, you need to collect a small amount of blood in a pipette. It also comes with the test.
• A drop of blood is applied to the window, which is located on the test itself. It also contains 2 drops of the reagent.
• Leave the test on a flat surface for 15 minutes.
• The result can be interpreted after the specified time. If one band appears in the indicator, then the test is negative, and if there are two bands, then the test can be considered positive.

Read more about express tests in the article: Rapid test for Helicobacter pylori - types of tests, pros and cons

To conduct a fecal test for Helicobacter pylori, you will need to collect a small amount of feces in a clean container. Laxatives should not be taken before testing. The material is collected with a cotton swab. To conduct a study, 125 g of feces are enough, which is placed in a test tube. Then a reagent is introduced into it. Shake the tube to obtain a homogeneous consistency. The material is held for 10 minutes, after which a small amount is applied to the test strip. Wait another 10 minutes. After this time, the result is evaluated. If one strip appears on the test, then it can be considered negative, and if there are two stripes, then positive.

It should be borne in mind that the doctor will not review and evaluate the results obtained at home. Also, on their basis, it is impossible to prescribe treatment. Therefore, if you suspect infection with Helicobacter pylori, you need to contact a specialist, undergo professional diagnostics and receive treatment adequate to the disease.

Author of the article: Danilova Tatyana Vyacheslavovna | Infectionist

Education: in 2008 received a diploma in General Medicine (General Medicine) at the Pirogov Russian Research Medical University. Immediately passed an internship and received a diploma of a therapist