Test for Helicobacter pylori - indications, essence, preparation, explanation, how to do it?

Indications for testing for Helicobacter pylori

The bacterium Helicobacter pylori is a gram-negative spiral-shaped pathogenic microorganism that inhabits the antrum of the stomach and intestines. The waste products of the bacteria lead to the fact that the mucous membrane of these organs of the digestive system will become inflamed, ulcers and erosions 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 by kissing or by using common household items. Therefore, the bacterium first enters the body most often in childhood. The acidic environment of the stomach is not capable of destroying the microorganism, since it has its own defense mechanisms against it.

Sometimes the disease begins to develop immediately after the infection has occurred, and sometimes after a certain time interval. Often, a bacterium can exist completely asymptomatically in the body for several years and manifests 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 should be done for those people who have symptoms of disorders of the digestive system, including:

Frequent belching.
Heartburn with secretion of acidic contents.
Hiccups.
Bad breath due to the health of the oral cavity itself.
Stomach pain, feeling of discomfort.
Abnormal bowel movements, in which diarrhea may be replaced by constipation.
Symptoms indicating a failure in metabolic processes: hair loss, dry skin, increased brittleness of nails.
Rapid saturation with small portions of food, disturbances in its digestion.
Meat intolerance.

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

The essence of the urease breath test for Helicobacter pylori

The breath test is based on the ability of bacteria to secrete a special enzyme - urease. It is necessary for Helicobacter pylori to prevent human gastric juice from destroying its lining.

In the stomach, urease breaks down urea into ammonia and carbon dioxide. The gas is released into the external environment. This is what the analyzer picks up.

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

Breath urease test using isotope-labeled urea. In this case, during the procedure, the subject drinks a solution of urea, which was previously labeled with isotopes.
13C-urease breath test. In this case, urea labeled with the stable non-radioactive isotope C13 acts as a loading solution.
Helic test. When conducting a helic test, they use not urea, but a urea solution.

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

The essence of the methods

A breath test is a safe procedure. The technique does not imply physical or psychological discomfort for the patient. There are two main testing options - the helic test and the C-urease test.

The methods differ in the type of component that reacts with air and is used for research.

C-urease breath test

Helicobacter pylori produces a special type of enzyme - urease. The substance accelerates the hydrolysis of urea. This process is accompanied by the active production of ammonium and carbon dioxide. If there are no pathogenic microorganisms in the patient’s digestive system, then there is no urease in the stomach. The examination takes on average forty minutes.

Testing reliability reaches 95%.

Testing stages:

the patient takes a capsule with a carbon-labeled urea reagent);
if Helicobacter pylori is present in the body, then after thirty minutes carbon dioxide and ammonia will begin to be present in the exhaled air;
a special device records all changes;
if carbon dioxide and ammonia are absent in the air, then the test result is negative (Helicobacter was not detected).

Breathing Helic test

The reliability of the helic test is 75%. Air testing is also carried out based on the ability of a microorganism to produce urease. To carry out the procedure, a urea solution is used. If the bacterium is present in the body, then under the influence of this substance ammonia vapor will appear in the exhaled air. Testing is carried out using an indicator tube. Ammonia vapor changes the color of the indicator.

Breath test for Helicobacter pylori (Hp+ or Hp-).

Preparation for the procedure

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

The study is prescribed no earlier than 3-6 days after taking antibiotics or antisecretory drugs. Also, 5 days before the procedure, you should avoid taking painkillers, antacids and NSAIDs. If a person takes any medications on an ongoing basis, he should consult a doctor about this to clarify the possibility of the procedure.
At least 3 days before the study, you will need to avoid drinking alcoholic beverages.
The day before the procedure, you should not eat foods that increase gas formation. It is recommended to remove potatoes, bakery and confectionery products, cabbage, peas and beans from the menu.
The evening before the test, you should have a light dinner. Meals should take place 2-3 hours before bedtime.
At least 6 hours must pass 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 are not allowed to smoke before the procedure. You need to give up tobacco 3-4 hours before the procedure.
Before performing the test, you should brush your teeth and rinse your mouth.
You can drink water for the last time an hour before the test, 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 to prepare for research

Preparation for the breath test should begin the day before the procedure. If at the time of testing the patient is undergoing drug therapy, then the date of the test is set by the doctor after the end of the course of medication.

Violation of the preparation rules may cause a decrease in the reliability of the results. Before the analysis, it is recommended to brush your teeth and rinse your mouth.

Preparation stages:

the procedure is carried out on an empty stomach in the morning;
if the test is carried out in the morning, then the last meal should be taken no later than 21:00 of the previous day;
Do not drink water for an hour before the procedure;
the diet the day before testing should exclude any legumes (regardless of the method of preparation);
do not smoke on the day of testing;
three hours before the procedure, you should not chew chewing gum;
the test cannot be performed during drug therapy;
taking medications ends two weeks before the procedure;
at least three days before the procedure, it is prohibited to drink alcoholic and carbonated drinks;
Dishes present in the diet during the day before the procedure should be easily digestible and digestible.

Recommendations for preparing for the test.

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

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

The patient is then asked to drink an isotope-labeled urea solution. After 15 minutes, another 4 air samples are taken. Care must be taken to ensure that the subject’s saliva does not enter the tube. To do this, he can remove it from time to time and smooth out the accumulated liquid. If it happens that saliva does get 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.

How the research is carried out

Breathing tests are carried out over a short period of time. Helic test and C-urease testing are carried out using different devices. In the first case, the results are deciphered immediately, in the second case they are compiled by laboratory specialists. During the procedures, it is important to follow all the rules. If you violate the algorithm of actions, the results may become unreliable.

C-urease breath test

Before the C-urease test, the patient should drink a glass of orange juice. If there are contraindications to the use of such a drink (for example, an allergy to citrus fruits), then it is replaced with an apple version. Next, the patient must hold his breath for a few seconds. The air is exhaled into a special bag. The device is immediately sealed hermetically.

Further:

the patient takes a capsule or solution based on urea;
the substance should spread throughout the mucous membranes of the stomach (the patient is asked to turn over from one side to the other);
after half an hour, the procedure with exhalation of air into the bag is repeated;
in some cases, air is taken twice with an interval of ten minutes;
Determination of changes in the composition of exhaled air is carried out in the laboratory.

Helic test

The bacterium Helicobacter pylori is the cause of most cases of stomach and duodenal ulcers, as well as chronic gastritis with low acidity. The helix test is carried out using a tube equipped with an indicator. The device is placed in the patient's mouth for seven minutes. The main rule is that inhalations and exhalations are carried out as usual. No saliva should get into the tube.

Otherwise, test results may become unreliable. At the second stage of the procedure, the patient takes a special solution. You should breathe into the tube again for the next seven minutes. The doctor records all changes in the air based on the indicator readings. If necessary, testing is repeated after thirty minutes. For example, if saliva gets into the tube.

How is the 13C-urease breath test performed?

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

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

This type of research has a number of advantages, including:

The diagnostic accuracy is high, reaching 100%.
The procedure is safe for health, since no radioactive substances are used during its implementation.
The research doesn't take much time. In general, 40 minutes is enough to complete it.

How is the helic test performed to identify Helicobacter pylori?

The helic test is carried out according to the same scheme as the 13C-urease breath test. The only difference is that instead of isotope-labeled urea, a person receives a solution of urea. Air is taken in 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 Helicobacter pylori in pregnant women and children. However, a number of experts question the accuracy of the results obtained. Therefore, the helic test is carried out only in Russia.

Express test for the detection of Helicobacter pylori in stool

It is possible to test for Helicobacter pylori using stool. The feces of a person infected with the bacteria will contain an antigen to which the device reacts.

Interpretation of 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 has not been infected.

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.
When the isotope concentration is in the range of 3.5-6.4%, they speak of an average degree of infection.
Severe Helicobacter pylori infection will be indicated by rates of 6.5-9.4%.
Extremely severe is indicated by values greater than 9.5%.

As a rule, the accuracy of the test is beyond doubt. It is possible to obtain a negative result only if the conditions for preparing for the study are not observed. Some drugs can reduce the activity of gastric juice production, which will make it impossible to break down urea.

Test results will be available 1-2 days after the test. The storage period for collected samples is 10 days, but no more.

Express test for detecting Helicobacter pylori in the blood

A visit to a laboratory or other medical facility for testing to detect Helicobacter pylori is not required. You can purchase the test at a pharmacy. Doing it at home is not at all difficult.

The test allows you to detect antibodies to Helicobacter pylori in whole blood.

The tests most often include:

Indicator tablet, which is packaged in an individual vacuum bag.
Reagent for diluting the obtained blood sample.
Pipette for adding blood to the tablet.
Scarifier suitable for single use.
Antiseptic wipe.
Instructions for use.

If the test was stored in the refrigerator, then it must be kept at room temperature for 20 minutes before use. Then the test is removed from the packaging and laid out on a dry, clean and flat surface. The indicator window should be located at the top.

Hands should be washed with soap, after which the package with a disposable antiseptic wipe should be opened and the finger from which the blood will be drawn is treated with it.

The next step is to open the scarifier. With its help, a small puncture is made on the tip of the finger to allow blood to flow out.

Blood is drawn into a pipette. One drop of liquid is enough to perform the test. It is introduced into the round window located on the express test tablet. After the blood is in the indicator, 2 drops of the reagent are added to it. Leave the test for 15 minutes, after which you can evaluate the result.

A line appears in the test area of the tablet. If there is only one line, then the person is not infected with Helicobacter pylori. If there are two lines, then the result can be considered positive. Thus, the total testing time does not exceed 20 minutes.

What to do 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 sent for an FGDS, which will provide information about the condition 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 damage to the inner wall of the stomach, a therapeutic regimen is selected. However, to eliminate bacteria, antibiotics are always used, which are combined with proton pump inhibitors. In this case, two antibacterial drugs will be prescribed. This may be Amoxicillin, Levofloxacin, Metronidazole, Clarithromycin, etc.

During treatment or after its completion, the doctor may suggest that the patient take another test for Helicobacter pylori. This is required to monitor the effectiveness of ongoing therapy or to evaluate treatment already performed. A gastroenterologist treats diseases of the digestive system.

In what cases should the test not be performed?

Due to the fact that the test does not involve any sudden interventions in the body or strong physical exertion, anyone can take it. The only thing that needs to be followed is the rules for preparing for the test. Thus, you can order a breath test for Helicobacter at any time at the LEKA-PHARM medical center, where well-trained specialists work.

Qualified medical care is waiting for you at the LEKA-PHARM medical center at any time convenient for you. We are waiting for your calls and appointments!