Early detection and eradication of H. pylori (Hp) infection slows the progression of atrophic gastritis and reduces the risk of gastric cancer in people with H. pylori infection without precancerous lesions of the stomach. How to find out if you have H. pylori infection? The following tests may be used.
Gastroscopy
Gastroscopy is one of the most common diagnostic methods for H. pylori. Once a specimen of gastric mucosa is obtained by gastroscopy, the doctor can test for it by a variety of means.
- Rapid urease test: (RUT) diagnoses H. pylori infection by detecting urease in the gastric mucosa using paper and gel methods. This method is inexpensive, rapid, simple, and highly specific, and is a rather practical invasive method that is recommended by our experts for the detection of invasive H. pylori infection.
- Histological examination: The mucosa obtained by gastroscopy is sectioned and then observed by the physician under a microscope. Often, histology is considered the gold standard for H. pylori infection testing and is one of the predominant tests.
- Isolate culture: Doctors use a specific method to isolate and culture stomach tissue biopsy samples to look for H. pylori. Although the method is expensive and time-consuming, it can test for susceptibility to antimicrobial drugs, which is a unique advantage. Physicians may choose this method in some areas with high rates of clarithromycin resistance or when second-line antimicrobial therapy is ineffective.
In addition to conventional endoscopy, phenol red-stained endoscopy, indigo-stained magnified endoscopy, and laser confocal microendoscopy may be used for H. pylori detection.
The breath test
The urea breath test (UBT) is currently the method of choice for noninvasive detection of H. pylori, with a high ability to detect H. pylori infection and less likely to misclassify those without infection as infected. The C-urea breath (UBT) test is the most widely used test.
Patients are asked to fast for 3 hours before the test. The nurse provides a bag and a capsule for the test. Half an hour after taking the capsule, the person exhales three breaths into the bag, seals the bag, and hands it to the nurse to complete the test. The doctor makes a diagnosis by measuring the amount of carbon dioxide in the breath sample.
To avoid missing the diagnosis, patients should stop taking proton pump inhibitors 2 weeks before the test and stop taking antibiotics 4 weeks before the test. Note that UBT is radioactive and should not be used in children or pregnant women.
Blood tests
The H. pylori antibody test makes the diagnosis by testing for antibodies in the blood. The method is inexpensive, rapid, and easily accepted by patients, and is widely used in epidemiologic investigations. The accuracy of the method is unaffected by the use of drugs such as bleeding ulcers, gastric atrophy, antibiotics, or proton pump inhibitors, which is unmatched by other methods. Usually, antibody testing is not used as the test of choice, and because antibody levels in the blood are maintained long after successful eradication, the method is also not used to assess the efficacy of eradication and cannot distinguish between recent or previous infection.
Summary
At present, the endoscopic rapid urease test (RUT) is the recommended method of choice for H. pylori screening in China, and the combination of RUT and histology improves the diagnostic accuracy and is the gold standard for H. pylori screening. the C-urea breath (UBT) test is the most widely used and is the preferred non-invasive test in China. In addition, there are some stool tests and other means. Patients need to be tested at a regular hospital to determine the presence of H. pylori infection.