Helicobacter pylori is a gram-negative, spiral-shaped bacterium that can infect parts of the mucous membrane of the duodenum and stomach and thereby provoke the development of gastritis, ulcers, duodenitis, cancers and lymphomas. But infection with this bacterium does not always cause these diseases. In 90% of cases, carriage of Helicobacter does not cause any pathology.
Symptoms of Helicobacteriosis
Frequent fasting pains that disappear after eating can indicate a stomach ulcer or duodenal ulcer, and therefore Helicobacter pylori infection. Pain in the epigastric region can be disturbing at night. Sometimes they subside after an alkaline drink, such as a glass of milk.
In addition, the presence of this infection in the body may be indicated by heaviness in the stomach, frequent heartburn or nausea. Vomiting, as a rule, does not happen. Sometimes patients note changes in taste preferences. There may be an aversion to meat dishes. Fatty meat food in such patients is poorly digested.
What studies confirm the presence of Helicobacter in the body?
There are several methods for determining the presence of this infection in the body.
- A blood test for antibodies to Helicobacter bacteria.
- The study of feces on the antigen of the pathogen.
- The breath test is not Helicobacter pylori.
- Cytological examination of the material obtained by fibrogastroduodenoscopy (FGDS).
As a rule, the diagnosis is made only after two methods of research on Helicobacter pylori were positive. To date, the most reliable and effective method for detecting this pathogen is to study the material obtained by endoscopic examination. But it is not always possible to carry out an invasive method for detecting this infection, for example, it is contraindicated for pregnant women, as well as children. It is appropriate for these categories of patients to perform a Helicobacter breath test. It is carried out quite easily and has no undesirable consequences.
Helicobacter pylori urea breath test
This research method is based on measuring the concentration of urea in the air exhaled by the patient after ingestion. The bacterium Helicobacter pylori is able to synthesize a special enzyme - urease. This enzyme has a cleavage effect on urea. Under the influence of urease secreted by bacteria, it breaks down in the intestines into components - ammonia and carbon dioxide, which is released by the lungs when breathing. Its concentration is also evaluated by conducting a Helicobacter breath test. The concentration of carbon dioxide is determined before the patient receives urea and then in several samples.
Indications
Patients are advised to undergo a Helicobacter breath test in the following cases:
- If there is a history of a stomach ulcer or duodenal ulcer.
- If gastritis is suspected, a duodenal ulcer or stomach.
- If the patient has complaints of severity and pain in the epigastrium, belching or heartburn.
- With non-ulcer dyspepsia.
- To monitor ongoing therapy for this infection.
How to prepare for the study?
In order for doctors to correctly evaluate the Helicobacter pylori breath test, you need to prepare for it. Otherwise, the analysis results may give incorrect information. In the case of taking certain medications, it can take up to three weeks to prepare the patient for this study.
- Three weeks before the study, you must stop taking antibiotics, bismuth preparations and antacids - these are drugs that lower the acidity of gastric juice.
- Three days before the study, it is forbidden to take any alcoholic beverages.
- The day before the analysis, you can not eat foods that increase gas formation (legumes, cabbage, black bread, potatoes, etc.).
- On the eve, dinner should be light and not too late.
- On the morning of the day of the study, you can not eat breakfast and smoke.
In the morning you only need to brush your teeth - this is necessary, but breathing with chewing gum is forbidden. If you really feel like drinking in the morning, then you can take a couple of sips of clean boiled water, but no later than an hour before the study.
A false-positive test can provoke a resection of the stomach or achlorhydria once made - a condition in which hydrochloric acid is completely absent in the gastric juice (it is not produced by the gastric cells).
How is Helicobacter breath test performed?
First, the medical worker offers the patient to breathe through a special tube. You need to breathe calmly, as a person does in a normal situation. At this stage, two exhaled breath samples are taken.
Next, the patient is offered to drink a 5% urea solution. After 5 minutes, a sample of exhaled air is taken by turning the indicator tube upside down. Thus, three more samples are taken. An increase in the concentration of ammonia in the air exhaled by the patient is evaluated.
If the ammonia concentration exceeds 0.5 mg / ml, the Helicobacter pylori respiratory test is considered positive.
The procedure does not cause any negative sensations. The inconvenience can only be delivered by saliva. For a correct assessment of the result, it should not fall into the tube, otherwise the test may be ruined. If it is not possible to swallow it, then it is periodically allowed to take small breaks and remove the tube. After swallowing saliva, research continues. If, nevertheless, saliva got into the indicator tube and the test failed, it can be repeated after 50-60 minutes.
How to choose a laboratory?
Modern test systems are automated, and the test is evaluated not by a person, but by a device. In addition, there are systems whose indicator tubes are protected from saliva. This makes the procedure more comfortable. And the study itself takes less time.
Before choosing a laboratory in which you are going to do a Helicobacter respiratory test, you should find out what methodology is used for this and what equipment will be tested.
The cost of the test can be quite high. It depends on the comfort for the patient and the accuracy of the study. Hardware research is more accurate.
How to evaluate the results?
So, we passed the Helicobacter breath test. Results are received. How to rate them? Evaluation of this study can be qualitative and quantitative.
A qualitative reaction is positive when the urease activity of these bacteria is detected, and negative if it could not be detected.
Quantitative research results are obtained using a special apparatus called a mass spectrometer. The result is estimated as a percentage. These figures show the percentage of stabilized isotope in the air exhaled by the patient, which can be used to assess the degree of infection of the gastric mucosa with Helicobacter pylori bacteria. There are four degrees of infection:
- Light - from 1 to 3.4%.
- Average - from 3.5 to 6.4%.
- Severe - from 6.4 to 9.5%.
- Extremely severe - more than 9.5%.
What is the norm when evaluating the results of such a study as a Helicobacter respiratory test? It is considered such an indicator when only traces of labeled carbon dioxide are detected in exhaled air. If urease activity is not detected, then the patient’s body is not infected with harmful bacteria. This is the norm.
The test is positive. What to do?
If the breath test for Helicobacter pylori test positive, as a rule, additional studies are prescribed that can confirm the presence of this bacterium in the patient's body. This may be a fecal test for the antigen of this bacterium or a blood test confirming the presence of antibodies to Helicobacter pylori. If additional studies are positive, the doctor will prescribe the necessary therapy.
Helicobacter pylori is the main etiological factor in the development of diseases of the gastrointestinal tract.