H. Pylori (Helicobacter pylori) is gram negative spiral bacteria causing a gastric ulcer. The incidence and prevalence of this infection is growing worldwide and this infection is the most common cause for gastritis, gastric ulcer, peptic ulcer, dyspepsia etc.
This infection can be detected by a urea breath test, serology (Elisa), stool examination and endoscopic examination. Amongst all these tests, the urea breath test is the fastest, safest and accurate test. So it is used very routinely by all gastroenterologist worldwide.
The urea breath test is a rapid diagnostic procedure used to identify infections by H. Pylori. The urea breath test is based on the ability of H. Pylori to break down urea, a chemical made up of nitrogen and carbon, into carbon dioxide which then is absorbed from the stomach and eliminated in the breath (Urea normally is produced by the body from excess or waste nitrogen-containing chemicals and then eliminated in the urine).
1. Fast for at least 6 hours prior to the test.
2. No smoking for 2 hours prior to the test
3. Ensure compliance with drug therapy. If you are taking some drugs (medications), you need to stop them prior to the test because these drugs can alter the results. These drugs are
You will ask to come in the morning after fasting. You need to be relaxed and calm. The procedure is very simple and safe.
Practically this test is not having any side effects. Till date, no adverse events during this test is noted. But Theoretically if a person is having an allergy to capsule or liquid then he or she can develop allergic reactions but again the possibility of this is very very rare.
The measurement of carbon isotope in the post-test sample will give us the result.
Urea labeled with carbon isotope metabolized by H. Pylori of the stomach. So this free isotope of carbon eliminate in a breath and shows a positive result.
If H. Pylori is not present in the stomach, the post-test sample will not show carbon isotope and hence test is labeled as negative.
Antibiotics and antacids are the mainstays of treatment for H. Pylori infection. Antibiotics like Clarithromycin and amoxicillin are best for H. Pylori infection.
In antacids, proton pump inhibitors (PPI) like pantoprazole, lansoprazole and esomeprazole are best. Commercially, H. Pylori Treatment kits are available which is having fixed doses of Clarithromycin, amoxicillin, and pantoprazole.
Duration of treatment is at least 2-3 weeks.
Along with medicines, certain lifestyle modifications like avoiding stress and tension avoiding oily and spicy food, avoiding large meals, weight reduction, smoking and alcohol deaddiction etc are also advisable.
Follow up: Your doctor might send you for follow up urea breath test after completion of treatment. If repeat test is negative then you are free from H. Pylori infection.
Dr. Kaushal M Bhavsar pursued his MD in Pulmonology. He is an Assistant Professor in Pulmonary Medicine, GMERS Medical College, Ahmedabad
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