Helicobacter pylori infection that causes more than 90% of duodenal ulcers and 80 % of the stomach ulcers can be very easily diagnosed today. For the group of patients younger than 45 years without serious, so-called “alarming” symptoms, diagnostic process can be carried out even in outpatient clinic of general medicine by one of non-invasive diagnostic methods. In case of positive findings, it is recommended to carry out the therapy of infection. The success of the therapy is controlled also non-invasively, primarily using simple and painless urea breath test.
How is Helicobacter Pylori infection revealed?
Diagnostic methods for the detection of HP infection are classified into two groups:
- invasive (examination with probe) – endoscopic examination with targeted sampling (biopsy – quick urease test, histology and culture),
- non-invasive (examination without probe) – methods that reveal the presence of HP
- breath test – proving the activity of urea bacteria by breath test,
- blood or saliva examination – the presence of specific antibodies in serum and/or saliva of infected person (this method is not good if therapy if already taken),
- stool – proves bacteria activity (HP antigen) in the stool of patient.
The choice of a diagnostic procedure to determine pylori infection in patients with heartburn and similar symptoms (dyspeptic disorders), and the first general practitioner visits, depends on the severity of symptoms and the age of the patient.
The European group for HP infections requires a different diagnostic approach in patients younger and older than 45 years.
For the group of patients younger than 45 years without severe symptoms (called “alarming symptoms”) diagnostic procedure can be carried out in general medicine outpatient clinic by one of the non-invasive diagnostic methods (urea breath test or detection of HP antigen in stool). In case of positive findings, it is recommended to carry out the infection therapy. The success of the therapy is controlled non-invasively as well, primarily using simple and painless urea breath test (blowing). Urea breath test is easily performed even in children.
“Alarming” symptoms:
- severe pain – that significantly affects the quality of life
- signs of bleeding (haematemesis – vomiting blood, melena – black stool)
- anemia
- severe vomiting
- considerable (unexplained) weight loss
- difficult or painful swallowing of food
- feeling a tangible formation in the stomach
- considerable signs of malnutrition
What is the diagnostic value of blood tests – serological diagnosis (determining the level of antibodies to Helicobacter Pylori in serum or blood)?
Although very simple, determining HP “from blood” is now less used. The reason lies in the large number of incorrect findings, especially when the test is used to control the success of the therapy. Namely, when the infection is successfully treated, the test may remain positive for months , and sometimes, years.
So today it is a generally accepted view that the blood test – serological diagnostics os used only if there is no possibility of better diagnostics, e.g. urea breath test, and then only if the patient has never before been treated for HP infection.
Endoscopy
In the group of patients older than 45 years, or for those with present “alarming symptoms” regardless of age, specialist gastroenterology and endoscopic examination of the esophagus, stomach and duodenal with HP infection diagnosis of gastric mucosa samples is recommended treatment.
Should Helicobacter Pylori infection be checked in people with no symptoms of the disease?
Basically, no! The only exception may be people who have close relatives which have cancer of the stomach, or those people who must take drugs such as aminosalicylates (aspirin, etc.) or antirheumatic drugs during their treatment, and who’ve felt gastric unease when taking such medicine.