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Diagnosis and Testing

There are several types of tests for H.pylori. The major ones have a their own forum.

Moderators: Toni, barjammar

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  • Overview of Diagnostic Tests
    There are several types of tests for H.pylori. They are usually classed as invasive (you need to have a 'scope put down) and non-invasive (it's just a blood sample or a breath sample). Tests can also be indirect (meaning they don't actually test for the germ itself, maybe just antibodies in the blood), or direct (these tests test for some activity caused by the bug itself so can be more accurate e.g. breath tests). "Direct" tests are said to test for "ACTIVE" infection which will require antibiotic treatment. Indirect tests can detect signs of a past or "INACTIVE" infection, in which case no treatment is required.
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  • Breath Tests (C14 and C13)
    Breath tests are the most accurate way of detecting H.pylori without actually having an endoscopy (stomach examination). Breath tests are especially useful after treatment to make sure H.pylori is cured. Urea breath tests are known to be completely harmless. Either C14-urea or C13-urea tests are used. Read about them at the diagnosis section at http://www.helico.com/diag_breath.html where a diagram can be found. C14-urea breath tests use a radioactive tracer but such a tiny amount that it can be used safely at any age. It is a 15 minute test, convenient and inexpensive. The C13-urea test uses a stable isotope of carbon which is also harmless but requires two breath samples and takes about 30 minutes. Both tests have accuracy greater than 90%.
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    Last post Re: Breath tests?
    by nikolay View the latest post
    Mon May 14, 2018 11:30 pm
  • Antibody type Tests (blood or urine antibody)
    Blood tests (for antibody) are used to screen for H.pylori. They remain positive for many months after treatment so can only be used as the initial test. Urine antibody is a "pregnanacy style" urine test. Accuracy is slightly less than blood tests. A negative blood test is good evidence that Hp is NOT present. Use it to exclude the diagnosis (but no test is 100% perfect remember).
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    Last post Re: Treatment
    by Sgiacc View the latest post
    Mon Jun 18, 2018 11:30 am
  • Faeces Antigen Tests (stool samples)
    H.pylori bacteria in the stomach will pass through the bowel and parts of the bacteria will end up in the feaces. To detect the bacteria a feces sample (only 1 or 2 grams is required) is refrigerated and sent to the lab. In the lab antibodies are used to show up presence of bacter (called ELISA testing). These tests can be made in a dipstick form for near-patient diagnosis. the accuracy of these tests varies but is about 90%. This is a test for ACTIVE CURRENT INFECTION so it can be used after treatment to see if H.pylori is gone. It is also an easy one for little children as no needle is required and no fasting or other preparation of the patient needs to be done.
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  • Stomach Biopsy (histology, rapid urease, culture, PCR)
    Biopsy tests (CLOtest, culture, histology) are done at endoscopy and are very accurate. They detect ACTUAL bacteria so they quickly become negative (24 hours or so) if Hp has been eradicated. However, drugs which inhibit Hp temporarily, such as antibiotics or Pepto-Bismol, may cause these tests to go negative. Just in case, back up a negative biopsy test with a serology - which should also be negative if Hp has never infected the patient. If the diagnosis of Hp is crucial to the patient's care, and the tests do not coincide, then one of them must be wrong!
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    Last post Re: false negative biopsy res…
    by Helico_expert View the latest post
    Sun May 27, 2018 7:30 am
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