Helicobacter pylori: what it is, what it tells you and when it’s tested

Helicobacter pylori is a bacterium that lives in the stomach. It is very common and often picked up in childhood. Many people have no symptoms, but it can cause gastritis and ulcers and, over the years, raise the risk of stomach cancer. The test shows whether you have it.

When it’s tested

Doctors mostly order it if you have had burning or pain in your upper tummy for a while, if you have had an ulcer, or if you take aspirin or anti-inflammatories long term and have had an ulcer before.

It is also looked for with iron deficiency anaemia that has no clear cause, with a vitamin B12 shortage, or if a close relative has had stomach cancer. After treatment it is repeated, to make sure the bacterium has gone.

It is not a routine blood test, and the most reliable test uses your breath or stool. That is why Rosa does not run it. Instead it measures ferritin, vitamin B12 and haemoglobin, which can show the shortages linked to this bacterium.

What it tells you, and what it does not

Breath test: you breathe into a bag before and after drinking a solution. It is the most reliable test without a gastroscopy, and it uses nothing radioactive. It shows whether the bacterium is there now.

Stool test: it looks for parts of the bacterium in a small stool sample. It also shows whether it is there now, and is a good alternative.

Blood test: it looks for antibodies. It shows you have met the bacterium, not that you have it today, because antibodies stay long after treatment. That is why it cannot check whether treatment worked.

That is why it is read together with other tests:

How to read the result

The report says positive or negative. The breath and stool tests sometimes also print a number, next to the lab’s cut-off: the one on your report is what counts.

Positive on the breath or stool test means the bacterium is there now. Your doctor usually prescribes treatment.

Negative means the bacterium is not there. It can be a false negative, though, if you took stomach acid medicines or antibiotics in the weeks before.

If your test is positive or negative

How to prepare for the breath test

Preparing well avoids a false negative. Usually:

Only stop medicines if your doctor tells you to, never on your own. If the burning comes back without them, ask your doctor what you can take meanwhile: some antacids do not affect the test.

What to do if the test is positive

Treatment works in most cases. Where to start:

What can skew the result

A few things can make a test look negative even when the bacterium is there.

When to worry

Talk to your doctor if:

Frequently asked questions

Which test is best: breath, stool or blood? The breath test is the most reliable without a gastroscopy. The stool test is a good alternative. The blood test only shows that you have met the bacterium, not that you have it now.

Do I need to stop medicines before the breath test? Often yes: stomach acid medicines usually about two weeks before. If you have taken antibiotics or bismuth in the last four weeks, the test is usually postponed. Only stop a medicine if your doctor tells you to, and follow the lab’s instructions.

What are the symptoms of Helicobacter pylori? Often none. When there are any, they are burning or pain in the upper tummy, feeling full quickly, nausea. An ulcer can cause stronger pain or bleed.

How do you catch Helicobacter pylori? It is thought to pass from person to person, often within families and in childhood. Exactly how is not fully clear. That is why many people have had it for years without knowing.

Do I need another test after treatment? Yes. At least four weeks after the end of treatment, the breath test, or the stool test, is repeated. The blood test is no use, because the antibodies stay.

Does Rosa test for Helicobacter pylori? No. Rosa measures ferritin, vitamin B12 and haemoglobin, which can show the shortages linked to this bacterium. If your doctor wants the test, they order it separately.

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