Helicobacter pylori (H. pylori) Tests
Reviewed
Also called: H. pylori stool antigen, H. pylori breath tests, urea breath test, rapid urease test (RUT) for H. pylori, H. pylori culture
H. pylori tests check for a common stomach bacteria that can cause peptic ulcers, gastritis, and increase stomach cancer risk. Most infected people have no symptoms. Testing helps determine if H. pylori is causing digestive problems and whether treatment has cleared the infection.
Specimen: breath, stool, or tissue (biopsy)
Urgent safety information
Get medical help right away if you have signs of stomach bleeding (black or tarry stool, red blood in vomit or vomit that looks like coffee grounds), sudden sharp belly pain that doesn't go away, dizziness or fainting, a rapid pulse, or other symptoms of shock. Also get help if you have a known ulcer and your symptoms worsen.
Why this test may be ordered
- To find out if an H. pylori infection is causing digestive symptoms such as upper abdominal pain, bloating, nausea, vomiting, burping, loss of appetite, or weight loss.
- To see if treatment has cured an H. pylori infection.
Preparation and collection
You may need to stop taking certain medicines for two weeks to a month before testing. For an endoscopy, you may need to fast for several hours. After endoscopy, you may be drowsy, so plan to have someone bring you home. Follow your provider's instructions.
Breath test: breathe into a container, swallow a urea pill or liquid, then provide another breath sample. Stool test: collect a sample in a clean container, avoiding urine, toilet paper, or water. Endoscopy: a thin tube with a camera is inserted through your mouth into your stomach; tissue samples (biopsy) may be taken.
Breath and stool tests have no known risks. Endoscopy may cause discomfort; serious complications are rare. There is a very small risk of a tear in the intestine. If a biopsy is taken, there is a small risk of bleeding that usually stops on its own.
Understanding results
Your healthcare provider will interpret your results. The following describes possible outcomes:
- Negative (normal): You probably don't have an H. pylori infection. Your provider may order more tests to find the cause of your symptoms. Limitation: A negative result does not completely rule out infection if you have taken certain medicines or if the sample was not collected properly. Next step: Your provider may recommend additional testing for other digestive conditions.
- Positive (abnormal): You have an H. pylori infection. Treatment with one or more antibiotics and other medicines is usually prescribed to relieve symptoms and help heal your stomach. Limitation: A positive result does not indicate the severity of infection or damage. Blood antibody tests cannot distinguish between a current or past infection. Next step: After treatment, your provider may order repeat tests to make sure all the bacteria are gone.
- Blood tests for H. pylori antibodies are not commonly used because they cannot tell if the infection is current or past.
- A negative blood antibody test usually means you did not have an infection when the sample was taken.
- Test accuracy can be affected by recent use of certain medications.
What to do next
Discuss all results with your healthcare provider. Do not change or stop any medications without consulting your provider.
- What do my test results mean for my health?
- Do I need any follow-up tests?
- Should I take any medicines before or after the test?
- What symptoms should I watch for and report?
Evidence source
U.S. National Library of Medicine: Helicobacter pylori (H. pylori) Tests