Detailed description of the study
Helicobacter pylori is a bacterium that affects the gastric mucosa due to its resistance to acidic environments.
It is assumed that infection with this infection occurs at an early age and is transmitted to children from parents or in preschool institutions. The most likely route of infection is considered to be the fecal-oral route of infection when living with an infected person in the same house, as well as during a long stay in a large group.
In addition, the oral route of transmission of infection through saliva and kissing has been recorded. There have been suggestions about the possibility of Helicobacter pylori infection during fibrogastroscopy - an examination through an endoscope that has been insufficiently treated with disinfectants.
After penetration into the stomach, Helicobacter pylori colonizes its mucous membrane, causing gastritis of the antrum of the stomach. The bacterium is protected from exposure to an aggressive acidic environment by producing alkali (ammonia) and some other substances that damage the gastric mucosa.
In response to Helicobacter pylori entering the body, the immune system produces antibodies. Initially, antibodies of class A and M are formed, they are soon replaced by immunoglobulins of class G. In most cases, the body is not able to completely defeat this infection, which predetermines the preservation of a high level of class G antibodies to it.
When combined with other unfavorable conditions, such as stress, poor diet, and infection with this bacterium, it leads to the formation of erosions and stomach ulcers. The following symptoms are noted:
1. pain in the upper abdomen (on an empty stomach);
2. nausea;
3. belching air;
Some people are asymptomatic when infected with Helicobacter pylori. Long-term damage to the gastric mucosa by this bacterium leads to the development of atrophy and decreased acid production. The risk of developing stomach cancer and lymphoma increases. A particularly high risk of developing cancer is observed in those whose relatives suffered from it.
Determining the presence of Helicobacter pylori infection in the body is important for early diagnosis of gastric pathology. Class G antibodies are produced several weeks after infection and are detected throughout life in the presence of bacteria in the body.
This test is relevant, in combination with other antibodies (IgA, IgM), as a primary diagnosis of this infection, but is not recommended for assessing the effectiveness of treatment, because IgG may persist for a long time even after successful therapeutic measures.
Tests for Helicobacter pylori. Which is the most effective?
In modern laboratory diagnostics, several methods are used to detect the presence of Helicobacter pylori in the body: using a blood test, stool test, breath test or biopsy. Why is analysis needed? A simple example: if a person has a clinical picture of gastritis, then you need to first understand the reason for its appearance and development, and only then prescribe treatment.
The main indications for testing for Helicobacter pylori:
- gastritis;
- constant heartburn;
- stomach pain after eating;
- frequent diarrhea and constipation;
- lack of appetite;
- flatulence, rumbling in the stomach.
Enzyme immunosorbent blood test for Helicobacter (ELISA)
Most often, gastroenterologists refer the patient for a blood test. However, you need to understand that there is no helicobacter bacteria in the blood. Using an enzyme immunoassay, antibodies to the presence of Helicobacter are detected in the blood, which are produced by the immune system in response to infection. This analysis cannot be called 100% accurate. The reason is that a person’s immune response can change at different points in life. For example, a patient had a sore throat, took a course of antibiotics, his immunity decreased due to the illness, the production of antibodies was impaired... In this case, the analysis will be false negative.
Stool analysis for Helicobacter
Using this simple analysis, Helicobacter pylori DNA can be detected in human biomaterial. The analysis is highly accurate – up to 95%. Suitable for young children, elderly people and those for whom biopsy is contraindicated. The study itself is carried out using the PCR (polymerase chain reaction) method. Research in the laboratory is carried out as follows: a section of DNA is isolated from the biomaterial, after which it is duplicated on a cycler. This makes it possible to determine whether the sample contains a genomic fragment characteristic of the Helicobacter bacterium.
Shortened rapid test for Helicobacter
The principle of the breath test is that bacteria are located in the submucous membrane of the stomach and during their life processes they release a large amount of urea. This urea is picked up by the breath test and gives a positive reaction. Before the procedure, the patient must take a special solution, after which 4 air samples are taken within an hour. The test result is visible immediately.
However, the test is also not 100% sensitive. It is worth noting that a shortened test for Helicobacter in Sochi can only be found in large medical institutions.
Culture for Helicobacter
This is the most sensitive method giving an accurate result. However, the study itself is quite complicated, since the material for the biopsy, which is a section of the gastric mucosa, is taken during gastroscopy. There is a need for prompt communication between the endoscopist and the LHC laboratory so that the biomaterial can be sent for examination immediately after the procedure.
The decision to prescribe a particular diagnosis is made by a gastroenterologist, depending on the clinical picture of the disease and the patient’s condition. Sometimes several tests will be needed to confirm the presence of bacteria in the body. Note that most often a blood test is prescribed. Less often - bacterial culture for Helicobacter. The most accurate would be bacterial culture, but from the point of view of the complexity of the procedure and comfort for the patient, this study is less preferable.
“According to the recommendations of the Austrian community of gastroenterologists who study Helicobacter, stool analysis and a breath test are prescribed to those patients who have already been treated for Helicobacter for control purposes,” explains Vladimir Kadushev, gastroenterologist at the ELISA Medical Center. – That is, primary diagnosis is carried out using enzyme immunoassay. But the bacteria's antibody titers, in other words their memory, can persist throughout life. For this reason, blood is not used for control testing.
Do I need to be tested for Helicobacter pylori again?
Yes, after a course of treatment it is necessary to take a repeat test for Helicobacter to assess the effectiveness of therapy.
How to test for Helicobacter pylori?
In order for the result of the study to be as accurate as possible, it is necessary to properly prepare for the analysis and follow the rules when submitting biomaterial.
- Preparing for stool donation
You should not take antibiotics at least a month before donating the biomaterial. Three days before going to the laboratory, do not eat so-called “coloring foods”: black currants, beets, grapes and others. The ban also applies to products with coarse fiber: carrots, radishes, cabbage, bran. A gastroenterologist will remind you of the need to stop taking medications that stimulate gastric motility. To collect biomaterial, you need to purchase a special container from the pharmacy. Try to deliver the biomaterial to the laboratory promptly, since the shelf life of the biomaterial is no more than 10-12 hours.
- Preparing for a blood test
On the eve of the blood test, exclude fatty and fried foods from your diet, do not smoke, do not drink alcohol, and avoid strenuous physical activity. Blood is donated in the morning on an empty stomach.
- Preparing for a breath test
You should not eat before taking a breath test. If you take the Helicobacter test in the morning, then your last meal should be no later than 22.00. 3 days before the test, remove from your diet foods that increase gas formation - apples, legumes, cabbage, baked goods. Avoid liquids that increase CO2 concentrations in your exhaled breath, such as carbonated water. The ban also applies to cigarettes, alcohol and chewing gum.
- Preparing for a biopsy
Before FGD with biopsy, you must refrain from eating for 12 hours. Also, 2 hours before the test you should not smoke or drink.
References
- Ivashkin V.T., Maev I.V., Abdulganieva D.I., Alekseenko S.A., Ivashkina N.Yu., Korochanskaya N.V., Mammaev S.N., Poluektova E.A., Trukhmanov A. S., Uspensky Yu.P., Tsukanov V.V., Shifrin O.S., Zolnikova O.Yu., Ivashkin K.V., Lapina T.L., Maslennikov R.V., Ulyanin A.I. . Practical recommendations of the Scientific Community for Promoting the Clinical Study of the Human Microbiome (NSOM) and the Russian Gastroenterological Association (RGA) on the use of probiotics for the treatment and prevention of gastroenterological diseases in adults. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020
- GuevaraB, CogdillAG. Helicobacter pylori: A Review of Current Diagnosticand ManagementStrategies. DigDisSci. 2020
- Choi IJ, Kim CG, Lee JY. Family History of Gastric Cancer and Helicobacter pylori Treatment. N Engl J Med. 2020
How is the Helicobacter test interpreted?
If the research is qualitative, then there can be only two results - “positive” or “negative”. If a quantitative method is used, the analysis standards will depend on the specific laboratory, and only a doctor can interpret them.
How can you become infected with Helicobacter pylori?
The bacterium Helicobacter pylori is called an intrafamilial infection and it occurs in 80% of the Russian population. The main modes of transmission: fecal-oral, oral-oral, household. This could be kissing, sharing utensils, eating insufficiently clean vegetables and fruits, failure to comply with personal hygiene rules... Most often, infection occurs in childhood through household contact. If, for example, parents have the bacterium Helicobacter pylori in their bodies, then it is passed on to their children. Another question is in what period of a person’s life it will manifest itself. Do not forget that most diseases of the upper digestive tract occur precisely because of this bacterium. Gastroenterologists warn that 100% of people with Helicobacter develop gastritis over time. Therefore, it is important to detect it and undergo treatment on time.
Blood tests
If the patient complains of pain in the stomach, any discomfort, with functional digestive disorders, with gastritis and peptic ulcers, a blood test is taken for Helicobacter pylori. Antibodies to helicobacter pylori in the blood are an indicator of human infection with the bacterium helicobacteriosis.
It is recommended to donate blood for Helicobacter bacteria if:
- weak immunity
- hereditary predisposition to stomach cancer
- as a preventive diagnosis
- to evaluate the treatment received for the infection.
How to prepare for the analysis?
Before the analysis, you must not eat food, coffee, tea, alcoholic drinks, or smoke 8 hours before the test. This test for Helicobacter pylori determines the amount of immunoglobulins. When a certain toxin enters the human body, a virus, microbe, immunoglobulins interact with them and neutralize these harmful substances. The analysis shows the interaction of the pathogen and immunoglobulins, which makes it possible to determine whether Helicobacter pylori is in the stomach or duodenum.
Advantages and disadvantages
Advantages of this test:
- the diagnostic procedure is not expensive;
- high accuracy of the result;
- analysis is available to everyone.
The test for Helicobacter pylori has its drawbacks:
- there are factors that influence the result of the analysis;
- some patients experience fear when taking blood;
- thorough results are obtained in 4-6 days.
Analysis transcript
Deciphering the result of a blood test for Helicobacter pylori can be done without medical skills. Antibodies are divided into categories A, G, M. Opposite each category there is a result on the form. If all blood test parameters for Helicobacter pylori do not exceed the norm, then there is no bacteria in the body:
- immunoglabulin LgG is absent or significantly lower than normal: bacteria are absent in the body;
- LgG detected: helicobacteriasis is present or has been previously experienced;
- immunoglabulin LgM was not detected or below the norm: conditional norm for Helicobacter pylori;
- LgM class detected: initial stage of the disease;
- immunoglabulin LgA is not detected in the blood: this may indicate an early stage of the disease, recent antibiotic therapy, or the patient is in the recovery stage.
Contraindications
A blood test for Helicobacter is not performed:
- for convulsions
- with increased excitability of the patient
- if there is skin damage at the injection site.
A blood test for antibodies is also not prescribed for venous phlebitis.
Stool analysis
PCR – what is it? This is a sensitive way to detect infection. It recognizes the DNA or RNA of the pathogen. For PCR, the material for research is feces.
A stool test for Helicobacter antigen is the most convenient test for the elderly, children and seriously ill patients. In this case, the presence of the patient in the laboratory is not required and the procedure is not associated with injury to the body. By the way, we will talk about Helicobacter pylori in children separately.
But detecting bacteria in stool is not easy. In the intestine, the microorganism is exposed to unfavorable conditions for it (bile acids, lack of oxygen). Therefore, active organisms adapt to new conditions, change their shape and their number sharply decreases.
A special method of polymerase chain reaction (PCR) is used, which allows you to determine the DNA fragment of a microorganism. The accuracy of the result is 95-96%.
What not to do before donating stool
It is important to know how to get tested for Helicobacter. Before donating stool, it is not recommended to take a lot of dietary fiber, coloring foods, inorganic salts, or medications that increase intestinal motility for 3-4 days.
Stool after an enema or laxative is not suitable for testing for Helicobacter.
A stool test for Helicobacter pylori is carried out before starting treatment. If the patient has previously taken antibiotic therapy for the treatment of any disease, it is better to prescribe a different method of examination.
Analysis transcript
The test result for helicobacter pylori can be positive or negative. A positive result indicates the presence or past infection. Negative data - about the absence of disease or incorrect conduct of the study.
Breath test - definition and its types
A breath test to detect Helicobacter pylori is a diagnosis of infection that allows you to identify the activity of Helicobacter pylori and assess the level of infection. Gastroenterologists, therapists, and pediatricians often use it in their practice. The Helicobacter pylori breath test is used for the initial diagnosis of the bacterium. They are also used to monitor the treatment process of the disease and check the effectiveness of therapeutic treatment.
The method is absolutely safe, the most effective and in demand in medicine today. The analysis shows the waste products of bacteria in the air that the patient inhales.
There are two main types of method. They differ in the reacting component:
- carbon
- ammonium
Carbon breath analysis provides a more accurate result.
Advantages and disadvantages of the method
This respiratory method has its advantages:
- The result is ready in a short period of time (20-25 minutes).
- Reliability of the result is 90-95%.
- The test does not harm the human body.
Since the method has only advantages, it has no contraindications. But the result will be accurate only if you prepare for the test correctly.
Preparing for a breath test
In order for the test to give the most accurate results, special preparation for the breath test is recommended:
- one month before the test, you should not take antibiotics;
- three days before the examination, do not drink legumes and alcoholic beverages;
- 6 hours before the test, do not eat anything;
- 14 days before the examination, avoid taking drugs that suppress the course; physiological and enzymatic processes in the body;
- You can’t chew gum or smoke for a few hours;
- the last meal no later than 22 hours, it should be a light dinner;
- one hour before the examination you can drink no more than 10 ml of water;
- for the analysis result to be accurate, the patient should not move;
- Before the examination, thoroughly clean your teeth and mouth.
It is very important to prepare for the test correctly, otherwise you will not get an accurate result. If the patient was unable to comply with all the rules, he must inform the doctor about this and another time will be assigned to him.
How the test is carried out
The procedure is carried out in a hospital setting under the supervision of a specialist. If the examination is carried out using a tube, the manipulation lasts no more than 15 minutes. If an electronic device is used, the procedure time is 10 minutes.
The procedure is simple:
- the patient takes a comfortable position
- a plastic tube is placed in the mouth, and breathing should be normal
- it is advisable not to touch the tube with your tongue and palate so that saliva does not get there
- if saliva accumulates, you can spit it out or swallow it, pull out the tube and take an air sample
- the first stage of manipulation lasts 6 minutes
- the patient is given a carbamide solution to drink
- the tube is placed back in the mouth
- the second stage also lasts 6 minutes, air testing is carried out
- after this the result is displayed.
Interpretation of analysis results and normal indicators
The norm is when the difference between the indicators of the first and second stages of the survey is zero. If there is Helicobacter in the body, the indicator will be above zero.
With the indicator:
- trace value is 1.5 -3.5, the microorganism is in an inactive phase and can be quickly gotten rid of;
- 3.5 - 5.5 – low level;
- small - up to 7 ppm;
- from 7 to 15, the bacteria is in the active phase, multiplying, the treatment process becomes difficult;
- above 15 – high level of contamination.
With any positive result, therapy should be started immediately, this will avoid complications and pain. But the Helicobacter treatment regimen must be drawn up by a doctor.
Contraindications for carrying out
The method has no contraindications, as it does not include any interventions or stress. It can be used for everyone, without restrictions.
Symptoms of infection
The test for Helicobacter pylori is carried out in cases where signs of gastrointestinal diseases appear:
- nausea (in combination with other symptoms);
- pain in the esophagus or stomach;
- heartburn;
- flatulence;
- diarrhea;
- constipation;
- blood in stool or during vomiting;
- weight loss;
- poor appetite.
However, Helicobacter pylori is not considered dangerous in all cases.
If the above symptoms do not bother you, and the test shows the presence of this bacterium, then it does not pose a threat to health.
FGDS with Helicobacter pylori
The endoscopic examination method is considered the most accurate test. A biopsy of the gastrointestinal tract reveals not only the presence or absence of bacteria, but also determines the stage of the disease, and also allows you to immediately find out whether the organs are affected or not.
This study is carried out using a gastroscope (a long tube inserted into the gastrointestinal tract through the mouth and equipped with a camera and a device for taking a tissue sample). In addition to taking biomaterial for biopsy, the gastroenterologist visually examines the condition of the walls of the duodenum and stomach.
Two hours before the biopsy, you should not smoke or drink, and your last meal should be 12 hours before.
FGDS with Helicobacter pylori can be performed under anesthesia. The procedure lasts about twenty minutes. The doctor will determine the ulcer, if any, during the examination, and the patient will receive the test results the next day.
Our clinic has the opportunity to conduct FGDS with Helicobacter pylori and other studies.
