Helicobacter pylori tests (stool antigen / urea breath test)

What it measures

Detects active H. pylori infection of the stomach. Stool antigen and urea breath tests are non-invasive and suitable both for diagnosis and for confirming eradication.

Specimen and preparation

• Specimen: Stool or breath sample
• Tube: Stool top
• Preparation: Stop PPIs 2 weeks and antibiotics/bismuth 4 weeks before testing; fast before breath test.

Reference range

Reference ranges differ between laboratories, methods and populations. Always use the range printed on your own lab report.

Causes of high values

• Active H. pylori infection
• Peptic ulcer disease and chronic gastritis
• Failure of eradication therapy (test ≥ 4 weeks after)

Method

Stool antigen ELISA or immunochromatography; 13C/14C urea breath test

Good to know

Serum antibody tests cannot distinguish past from current infection and are not used to confirm cure.

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