Digestive

H. Pylori Test: Complete Guide

H. pylori is a common bacterium linked to peptic ulcers and stomach cancer. Choosing the right test matters for accurate diagnosis and treatment monitoring.

Infects
~50% of world population (varies by region)
Best test
Breath test or stool antigen
Blood antibody test
Less useful — stays positive after cure
Requires
Stop PPIs 2 weeks before testing

Test Comparison

TestAccuracyNotes
Urea breath testVery accurate (95%+)Preferred for initial diagnosis and confirming eradication
Stool antigen testVery accurate (95%+)Good alternative, especially for children
Blood antibody testConfirms past exposure, not current infectionAntibodies persist even after successful treatment — not useful for confirming cure
Endoscopy with biopsyVery accurateUsed when endoscopy is needed anyway for other reasons

Important Testing Preparation

Test to Confirm EradicationAfter H. pylori treatment, a follow-up breath or stool test (at least 4 weeks after finishing antibiotics and 2 weeks off PPIs) confirms successful eradication — this is especially important if you had a peptic ulcer.
Should everyone with indigestion be tested for H. pylori?
Testing is generally recommended for those with peptic ulcer symptoms, or persistent indigestion not responding to simple measures, particularly before starting long-term acid suppression.
Can H. pylori cause cancer?
Chronic H. pylori infection is a recognised risk factor for stomach cancer and MALT lymphoma, which is part of why eradication is recommended when infection is found.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.