which test is most accurate for h pylori

Full Answer

Can blood test tell if you have H. pylori?

Blood tests for H pylori can only tell if your body has H pylori antibodies. It cannot tell if you have a current infection or how long you have had it. This is because the test can be positive for years, even if the infection is cured. As a result, blood tests cannot be used to see if the infection has been cured after treatment.

Do you always test positive for H pylori?

Your doctor doesn't know what he's talking about. You do NOT always test positive once you've had it. The DEFINITION of H pylori being gone is that you don't test positive for it anymore. However, in your case you should not have taken the test so soon after treatment.

What is normal result for H pylori?

Normal result of the test is the absence of antibodies to H. pylori in the blood sample. What do negative Helicobacter pylori IgG test result mean? Negative test result means there are no antibodies against the H. pylori bacteria in the blood.

Is a blood test for H. pylori reliable?

Unfortunately, the blood antibody test will show positive traces of H. pylori, even long after the bacterium has actually been treated successfully. So is not a good idea to use an H. pylori blood test after you have been treated! The stomach biopsy test is not only expensive but also scary for many of us.

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Which test is best for Helicobacter pylori?

A lab test called a stool polymerase chain reaction (PCR) test can detect H. pylori infection in stool. The test can also identify mutations that may be resistant to antibiotics used to treat H. pylori .

Which type of H. pylori testing is no longer recommended?

H. pylori IgG serologic testing is no longer recommended by clinical guidelines. Due to the high seroprevalence and since antibodies may persist for years beyond acute disease, this test is unable to accurately distinguish between past and current infection.

How accurate is the blood test for H. pylori?

pylori present on histology. When compared with histology results, the results of the 13C-urea blood test had a sensitivity of 89 percent, a specificity of 96 percent and accuracy of 93 percent.

Is breath test or stool test better for H. pylori?

When we looked at all the data we found that urea breath tests were more accurate than blood and stool tests. The results mean that, on average, if 1000 people are tested, there will be 46 people without H pylori who will be misdiagnosed as having H pylori.

What happens if antibiotics don't work for H. pylori?

When multiple treatment regimens fail, salvage therapy regimens such as bismuth or furazolidone quadruple therapy (a bismuth and tetracycline HCl 4 times a day along with a proton pump inhibitor twice a day, and either metronidazole 400 or 500 mg three times daily or furazolidone 100 mg three times daily for 14 days) ...

What is the fastest way to cure H. pylori?

Antibiotics to kill the bacteria in your body, such as amoxicillin, clarithromycin (Biaxin), metronidazole (Flagyl), tetracycline (Sumycin), or tinidazole (Tindamax). You'll most likely take at least two from this group. Drugs that reduce the amount of acid in your stomach by blocking the tiny pumps that produce it.

Can endoscopy Miss H. pylori?

Despite national and international guidelines (18,21) for the clinical management of H pylori infection, H pylori bacteria can be – and frequently are – missed on endoscopy.

Can you test negative for H. pylori and still have it?

In any ulcer patient with an H. pylori-negative test, it is important to consider that the test may be falsely negative due to treatment with antibiotics, bismuth preparations, or potent acid inhibitory therapy.

What can cause a false negative H. pylori test?

False negative results may be observed in patients who are taking antisecretory therapy, bismuth, or antibiotics and patients with upper gastrointestinal bleeding [31]. To reduce false negative results, the patient should be off antibiotics for at least four weeks and off PPIs for at least two weeks [9].

Can H. pylori be misdiagnosed?

Accordingly, AIG patients infected with such bacteria are often misdiagnosed as infected with H. pylori refractory to eradication therapy, because these bacteria do not disappear from the stomach but are replenished from the intestinal flora or oral cavity flora, or both.

What is H. pylori blood test called?

pylori) Antibodies Blood Test, IgA is used to diagnose H pylori infection in patients with duodenal disease and for monitoring the eradication of H pylori following antimicrobial therapy; identify the small percentage of H pylori-infected patients who fail to mount a systemic IgG response and demonstrate IgA antibodies ...

How long do you take antibiotics for H. pylori?

Medications — No single drug cures H. pylori infection. Most treatment regimens involve taking several medications for 14 days. Most of the treatment regimens include a medication called a proton pump inhibitor.

How accurate is H. pylori IgG?

H. pylori infection, the IgG test demonstrated very high sensitivity and specificity figures (100 and 99%, respectively) and PPVs and NPVs (95 and 100%, respectively) (Table ​ 3). In the older age groups, the sensitivity of the IgG test was high (over 98%).

How accurate is the H. pylori stool antigen test?

The sensitivity, specificity, accuracy and their 95% CIs of ImmunoCard STAT! ® HpSA test for identification of H. pylori infection were 76.9% (60/78, 95% CI: 66–86%), 97% (261/269, 95% CI: 94.1–98.6%) and 92.5% (320/347, 95% CI: 89–95%), respectively (Table 3).

What is serology test for H. pylori?

Serology tests employ enzyme linked immunosorbent assay to detect serum H. pylori–specific immunoglobulin G and immunoglobulin A antibodies. The fecal H. pylori antigen test is performed using either a monoclonal or polyclonal enzyme immunoassay.

How is a urea breath test done?

You'll drink a special liquid that has a substance called urea. Then you'll breathe into a bag, which your doctor will send to a lab for testing. If you have H. pylori, the bacteria will change the urea in your body into carbon dioxide, and lab tests will show that your breath has higher than normal levels of the gas.

How to test for H. pylori?

But, one of the most simple and inexpensive tests is actually the most accurate and easy way to identify a population of H. Pylori – a stool test. The National Institutes of Health point out that studies show that the faecal antigen test was not only the most accurate H. Pylori test for providing diagnosis, but also the most cost effective. The study also mentions that while the urea breath test is a non invasive option like the stool sample, that the test can be difficult. And, blood samples are easy to obtain, but results are less accurate than other means when testing for H. Pylori.

Why do you need a H pylori test?

Once suspected, an H. Pylori test can be ordered in order to accurately determine if the stomach residing bacterium are to blame for symptoms. h pylori, h pylori treatment, indigestion pain.

What is the cause of peptic ulcers?

It has recently been determined to be a major contributing factor to peptic ulcers, with an H. Pylori infection being one of the most common causes behind medication use. Previously, it was thought that acid reflux from spicy foods and stress were ...

What test is used to test for H. pylori?

Another type of test used to identify the presence of the bacterium is a urea breath test. This test can help to determine if an active infection is present and if the bacterium exists in the stomach.

How to determine if a person has H. pylori?

There are several different methods for determining whether H. Pylori is present in symptomatic individuals. One of the most common is a blood test . WebMD explains that this test is used to determine whether or not the body has begun to produce antibodies to H. Pylori, which then can help identify if the bacterium is present.

Is indigestion a sign of peptic ulcers?

Indigestion pain is one of the first symptoms of ulcers resulting from H . Pylori. And, this discomfort is often the result of an underlying condition, which peptic ulcer certainly qualify as. Proper medical diagnosis of indigestion pain is often difficult.

Is a stomach biopsy invasive?

In some cases, a stomach biopsy may be used as a more invasive means of determining the presence of H. Pylori. While certainly not the most cost effective route, it can be very effective at identifying the existence of the bacterium in the stomach.

What is the cause of peptic ulcers?

pylori is a type of bacteria (germs) that causes infection in the stomach. After H. pylori enter your body, it attacks the lining of your stomach, as a result, acid can get through the lining, which leads to Peptic ulcers, gastritis, and G.E.R.D. Infection with H. pylori is very common.

How many types of H pylori tests are there?

There are 4 different types of H. pylori tests…

What is the most accurate test for H pylori?

The most accurate test for H Pylori. A stool culture is used to detect the presence of pathogenic bacteria and help to diagnose an infection. A stool test is the best test for H pylori, as it is inexpensive, it’s easy, and you just need to provide a stool sample.

Is a stomach biopsy expensive?

The stomach biopsy test is not only expensive but also scary for many of us. During an endoscopy, you lie on your side and a thin tube with a camera is passed down to your esophagus and into your stomach.

Can an endoscopy show bacterium?

Endoscopy is fantastic if you want to identify stomach and duodenal ulcers or gastritis, but if you just want to see if the bacterium is there, is not the best test.

What is the gas that H pylori reacts with?

H pylori reacts with stomach acid to form a gas called urea. Doctors can analyse your breath for the presence of urea, and when it reaches a certain level they diagnose H pylori. Unlike the H pylori blood test and endoscopy, the breath test is non-invasive – you don’t have to have anything stuck in you to do the test!

Why does H pylori show up on a blood test?

Because it gives H pylori a chance to regrow and show up on a test. Testing too soon may give a false negative because H pylori is still there, it’s ready to spread, but it’s not in high enough numbers when you retest to show a positive result. DON’T use the blood test for retesting – it’s pretty a waste of time.

What to do if H pylori is negative?

TIP: if you have all the hallmark H pylori symptoms, or intuitively feel you are infected, yet your blood test is negative, get a breath test, stool test or endoscopy to double-check. Finally, a blood test means having a blood draw, which some people don’t enjoy, and which can be inconvenient.

Why does H pylori lose accuracy?

Like the breath test, the H pylori stool test also loses accuracy if you’re taking PPI medications to block stomach acid production.

How long should I wait to take a breath test for H pylori?

Experts recommend you avoid PPI medications for two weeks before taking the test. As with the tests already mentioned, you need to to travel to a clinic in order to do the test. But because it’s non-invasive, the breath test is one of the best test for H pylori. Nonetheless, if you have H pylori symptoms and you get a negative breath test, ...

How many different H pylori tests are there?

There are four different H pylori tests and they all have benefits and drawbacks.

What test can be done to check for H pylori?

The endoscopy is the only test that can assess the structural health of your upper GI tract. If your doc suspects H pylori, he or she can take a biopsy, which is a small snip of tissue that’s assessed for the presence of H pylori.

What is the H pylori test?

Helicobacter pylori ( H pylori) is the bacteria (germ) responsible for most stomach (gastric) and duodenal ulcers and many cases of stomach inflammation (chronic gastritis).

What is urea in a breath test?

Urea is a waste product the body produces as it breaks down protein. The urea used in the test has been made harmlessly radioactive. If H pylori are present, the bacteria convert the urea into carbon dioxide, which is detected and recorded in your exhaled breath after 10 minutes.

How do you know if you have H pylori?

Symptoms include a feeling of fullness or of heat, burning, or pain in the area between the navel and the lower part of the breastbone during or after eating. Testing for H pylori without endoscopy is most often done only when the discomfort is new, the person is younger than 55, and there are no other symptoms. Normal Results.

What is the purpose of blood tests for H pylori?

Blood tests are used to measure antibodies to H pylori. Antibodies are proteins made by the body's immune system when it detects harmful substances such as bacteria. Blood tests for H pylori can only tell if your body has H pylori antibodies. It cannot tell if you have a current infection or how long you have had it.

Why do you need a biopsy?

Usually, a biopsy is done if endoscopy is needed for other reasons. Reasons include diagnosing the ulcer, treating bleeding, or making sure there is no cancer.

How long before a syringe test can you stop taking antibiotics?

Up to 2 weeks before the test, you need to stop taking antibiotics, bismuth medicines such as Pepto-Bismol, and proton pump inhibitors (PPIs).

Can you get tested for H pylori?

If you had a stomach or duodenal ulcer in the past, and were never tested for H pylori. After treatment for H pylori infection, to make sure there are no more bacteria. Testing may also be done if you need to take long-term ibuprofen or other NSAID medicines. Your health care provider can tell you more.

How specific is a rapid urease test?

In general, the commercial rapid urease tests have specificity above 95%-100% and sensitivity above 85%-95%. Increasing the number of gastric antral biopsies could increase the sensitivity of RUTs and dual biopsy specimens from gastric corpus and antrum are preferred than only antrum biopsy specimens as additional corpus biopsy increase the diagnostic accuracy and avoid sampling bias due to uneven distribution of H. pyloriin stomach. Moreover, combining antrum and corpus specimens prior to RUT, rather than separate specimens, also increased the sensitivity of RUT and accelerate the reaction time[32,36-39]. Avoid medications that affect the urease activity and the density of bacteria is recommended before RUT to decreased false negative results, such as 2 wk for PPI and 4 wk for antibiotics. Bleeding significantly decreases the sensitivity and specificity of RUTs and make RUT become a more unreliable test than other tests in this clinical condition[40]. In a study evaluated the influence of different biopsy number and site on results of RUT in patients with peptic ulcer bleeding demonstrated that four biopsies from antrum or one biopsy from body increased the sensitivity of RUT as compared with only one biopsy from antrum. In this study, sensitivity of one biopsy from antrum was 64%, whereas sensitivity of four biopsies from antrum and one biopsy from body were 74% and 73% respectively[41]. If RUT is still chosen for patient with gastrointestinal bleeding, biopsies from both antrum and corpus were suggested to increase the diagnostic accuracy.

How specific is culturing of H. pylori?

Culturing of H. pylorifrom gastric biopsy specimen is a highly specific but less sensitive method. In general, culturing has almost 100% specificity, but the sensitivity of culture shows significant variation, between 85%-95%. Because of the delicate and fastidious nature of H. pylori, the cultivation in vitro requires particular transport medium, growth medium and incubation environment. Biopsy specimens can be kept in a transport medium, like Portagerm pylori or Stuart’s transport medium, for up to 24 h at 4 °C. Several types of agar can be used for culture as H. pyloriare isolated. The commonly used media include Pylori agar, Skirrow agar, Columbia blood agar, Brucella agar, Brain heart infusion or Trypticase soy agar, supplemented with sheep or horse blood. The agar plates are usually incubated in a microaerobic environment (80%-90% N2, 5%-10% CO2, 5%-10% O2) at 35 to 37 °C for at least 5-7 d because H. pylorihas been considered a microaerophile. However, a recent study showed growth of H. pyloriis promoted by atmospheric oxygen levels with the presence of 10% CO2, bringing a novel concept that H. pylorimay be a capnohilic aerobe[42]. Diagnosis of H. pylorifrom culture medium is based on morphological characteristics as well as positive urease, catalase, and oxidase reactions, which mean the microbiological laboratories should be equipped and trained to isolate this bacterium.

What is the endoscopic exam for H pylori?

Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis , MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. Antrum is a preferential biopsy site for detecting H. pyloriinfection in most circumstances, but corpus biopsy from greater curve is suggested for patients with antral atrophy or intestinal metaplasia to avoid false negative results[6,7]. The uneven distribution of H. pyloriin the stomach in different clinical setting inevitably leads to sampling errors in biopsy-based examinations and several attempts have been made for real-time diagnosis of H. pyloriinfection during endoscopic examination.

How accurate is PCR for H pylori?

pylorifrom gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. PCR provides excellent sensitivity and specificity, greater than 95%, as compared with other conventional tests and has more accurate results of detecting H. pyloriin patients with bleeding. Several target genes including UreA, glmM, UreC, 16S rRNA, 23S rRNA, HSP60, and VacAgenes, had been used for detection of H. pyloriand using two different conserved target genes can increase the specificity, which in turn avoids false positive result, especially for samples other than gastric biopsy specimens. The other advantages of PCR, including fewer bacteria required in sample, faster results, and no need for special processing supplies or transportation, enable clinicians to make quicker and more accurate decision on patient’s treatment. Furthermore, PCR also allows concurrent detection of specific mutations leading to antibiotic resistance, such as macrolide- and fluoroquinolone-resistance, and virulence factors, such as CagA and VacA[49-51].

What is the best stain for H pylori?

Staining is the critical part of histological exam and several stains like routine HE staining, Giemsa, Warthine-Starry, Hp silver stain, toluidine blue, acridine orange, McMullen, Genta, Dieterle, and immunohistochemical stain have been used to detect H. pylori. Although immunohistochemical stain is the most sensitive and specific stain, HE stain is usually sufficient for diagnosis of H. pyloriinfection in routine clinical practice. Ancillary stain is usually recommended for biopsy specimens which revealed moderate or severe chronic gastritis, but no H. pyloriidentified in HE staining. Furthermore, immunohistochemical stain should be the first choice if ancillary stain is decided to use for detecting H. pylori[24,25]. If immunohistochemical stains are not available, Giemsa stain is the preferred method in clinical practice because it is simple, highly sensitive and less expensive[26].

Why are serological tests important?

Serological test also play an important role in studies of pathogenesis and virulence factors because several antigenic proteins can be detected by immunological techniques and provide additional diagnostic value. Several attempts have been made to find potential biomarkers to identify patient infected with high-risk H. pyloristrains by serological tests. Levels of pepsinogen (PG) I, PG II and PG I/II ratio combined with H. pyloriantibody have been widely used to predict atrophic gastritis and risk of gastric cancer[108,109]. PG I/II ratio can also be useful in gastric cancer surveillance in patients after eradication therapy[110]. However, controversial results are presented on the clinical application of these serological makers. A recent study evaluating the accuracy of GastroPanel, which measures gastrin-17, H. pyloriantibody, PG I and PG II, to detect atrophic gastritis showed only 50% sensitivity and 80% specificity, which were inferior to previous studies[111]. Pepsinogen test was also not accurate enough for the diagnosis of gastric cancer, with 71.0% sensitivity and 69.2% specificity[112]. Some virulence factors have also been evaluated to predict the prognosis of H. pylori-associated diseases. Presences of serum CagA, VacA, and GroEL antibodies in patients with H. pyloriinfection are associated with gastric precancerous lesions as well as gastric cancer and these serum markers might serve as potential predictors for patients infected with high-risk strains, which may be related to the development of gastric cancer[106,113]. Although the association between virulence factors and clinical presentations had been found by previous epidemiological studies, serological tests are still not reliable enough for diagnosis of gastric cancer. In a recent meta-analysis, the pooled sensitivity and specificity of CagA antibody using to diagnose gastric cancer were 71% and 40% respectively, and the diagnostic odds ratio were 2.11[114].

Is Helicobacter pylori a Gram-negative or Gram-positive?

Helicobacter pylori(H. pylori) is a Gram-negative, microaerobic human pathogen and H. pyloriinfection is strongly related with many gastroduodenal diseases including chronic active gastritis, peptic ulcer diseases, atrophic gastritis, mucosa associated lymphoid tissue (MALT) lymphoma and noncardia gastric cancer. H. pyloriinfection affects more than half of the adult population worldwide, but the prevalence of H pyloriinfection varies widely by geographic area, age, race, and socioeconomic status. Usually, the prevalence of H. pyloriincreases with age in most countries, however a decline in prevalence of H. pyloriinfection has been observed in recent decades in time trend analysis of several large populations[1]. More than 80% of peptic ulcer diseases are caused by H. pyloriinfection and the estimated lifetime risk for peptic ulcer disease in H. pylori-infected patients is approximately 15%[2]. Gastric cancer is the third leading cause of cancer-related death worldwide and H. pyloriinfection is responsible for 74.7% of all noncardia gastric cancer cases[3,4]. Gastric cancer and peptic ulcer together cause more than a million deaths per year in the world and H. pyloriinfection always is an important health issue[5]. Various diagnostic methods are developed to detect H. pyloriinfection and diagnostic tests with both high sensitivity and specificity, exceeding 90%, are necessary for accurate diagnosis of H. pyloriinfection in clinical practice. Although many diagnostic tests are available now, each method has its own advantages, disadvantages, and limitations. The choice of one method or another could be depended on availability and accessibility of diagnostic tests, level of laboratories, clinical conditions of patients, and likelihood ratio of positive and negative tests on different clinical circumstances. Diagnostic tests are usually divided into invasive (endoscopic-based) and noninvasive methods. Invasive diagnostic tests include endoscopic image, histology, rapid urease test, culture, and molecular methods. Non-invasive diagnostic tests included urea breath test, stool antigen test, serological, and molecular examinations. In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions (Table ​(Table11).

How to test for H pylori?

The H. pylori infection can be detected by submitting a stool sample (stool antigen test) or by using a device to measure breath samples after swallowing a urea pill (urea breath test). For both of these tests to be reliable, it is important to stop taking acid-reducing medications called proton pump inhibitors (like Prilosec, Nexium, Protonix) for two weeks, and to avoid any bismuth products (like Pepto-Bismol) or antibiotics for four weeks before the test. Blood tests (serology or antibody test) are no longer recommended for most people because there are more false positives (abnormal test result when you may not have the infection), and this blood test can’t help tell whether you’ve had the infection in the past or have a current active infection. If you have specific risk factors for stomach cancer, your doctor may recommend starting with an upper endoscopy. For this test, a flexible tube with a camera is passed through the mouth and into the digestive tract. During an endoscopy the doctor can take tissue samples (biopsies) if necessary, as well as do H. pylori testing.

How long after treatment can you test for H. pylori?

It is best to avoid ones you have already used often, as it is more likely the H. pylori will be resistant to these. Most experts recommend testing four or more weeks after treatment ends to confirm the infection is cured. If it isn’t, this means trying another therapy with a different combination of antibiotics.

What to do if you have H pylori?

Testing correctly is important to reliably diagnose the infection and avoid unnecessary treatment.

How does H. pylori spread?

The bacteria are thought to spread through contaminated water, vomit, or feces. Most infections are acquired in childhood and often within families, especially in developing countries.

How long does it take to cure H pylori?

pylori. Treatment for H. pylori infection is challenging. It usually involves taking a combination of three or four medications multiple times a day for 14 days. And rising antibiotic resistance has made it increasingly difficult to cure the infection.

Why is it not recommended to take a blood test for an infection?

Blood tests (serology or antibody test) are no longer recommended for most people because there are more false positives (abnormal test result when you may not have the infection), and this blood test can’t help tell whether you’ve had the infection in the past or have a current active infection.

Can H pylori cause ulcers?

While fairly common, this infection usually causes no symptoms, but it can sometimes lead to ulcers in the stomach or the very first part of the small intestine (duodenum), and to certain types of stomach cancer. There is also evidence linking H. pylori infection to other conditions like iron-deficiency anemia and vitamin B 12 deficiency.