Helicobacter pylori – what and why does a practicing doctor need to know about diagnosis and treatment? Treatment of Helicobacter in the stomach HP disease

This bacterium is by far the most studied in the world, since it is the only one among microorganisms that can survive in the aggressive environment of the stomach.

It has been proven that 2/3 of the world's population is infected with this microbe.

How can you become infected with Helicobacter pylori?

The exact mechanism of infection is not known. It is assumed that Helicobacter pylori is transmitted by the fecal-oral and oral-oral (through kissing) routes. You can become infected when:

using shared utensils;
close physical contact;
poor handling of medical equipment (endoscope);
sneezing and coughing;
failure to comply with hygiene rules.

Infection often occurs when using contaminated water and food, mainly fruits and vegetables from the garden. Children receive this microbe from their mother through saliva, spoons and other objects.

Symptoms of Helicobacter pylori

After Helicobacter pylori enters the stomach, it begins to secrete its waste products and damage the epithelium of the stomach, thereby causing unpleasant symptoms.

Several forms of helicobacteriosis can be identified:

1) Latent form. For many people, the microorganism does not cause painful symptoms if the immune system is sufficiently strong. The bacterium can acquire an inactive form and become active under favorable conditions. There are also less or more harmful strains that are capable of affecting the mucous membrane to varying degrees.

Even with asymptomatic carriage, there is a functional disorder not only of the stomach, but also of the pancreas. And if the microorganism remains in the human stomach for a long time (more than ten years), serious consequences can develop, possibly degenerating into cancer.

2) manifested by pain in the epigastric region, vomiting. Usually becomes chronic.

3) . It is found in most of the world's population and is the main manifestation of helicobacteriosis.

Frequently concerned:

periodic pain in the stomach;
nausea;
feeling of a full stomach;
heartburn;
increased bleeding of gums;
bad taste in the mouth;
belching.

4) Chronic gastroduodenitis. The duodenum is involved in the process. The symptoms are similar to those of gastritis. Diarrhea or constipation, loss and decreased appetite may occur. The severity of changes, based on the results of endoscopy, can be mild, moderate or severe.

5) develops under the influence of various factors (smoking, alcohol, stress), but not for everyone. Ulcers and erosions appear when the deeper layers of the gastric walls are affected. The clinical picture of symptoms is varied. Pain in the upper abdomen is usually associated with eating. There is also heaviness in the epigastric region, heartburn, nausea, vomiting, and belching.

Helicobacter pylori symptoms on the face - photo

In 85% of people suffering from the disease, the symptoms of which manifest themselves in the form of acne on the face, the bacterium Helicobacter pylori was discovered. In addition, it can cause bad breath.

Diagnostic methods and analysis for Helicobacter pylori

There are several methods of examination for the presence of Helicobacter pylori infection.

One of the most common and reliable is fibrogastroscopy with biopsy. Mucosal tissue is examined for the presence of urease and Helicobacter pylori antigens. The effectiveness depends on the location where the biopath is taken.

Other examinations are also used for diagnosis:

stool test for H. pylori antigen. Particles of bacteria are found in feces and on this basis one can judge their presence in the stomach;
detection of bacteria in saliva and gum transudate;
Isolation of Helicobacter pylori culture (bacteriological method);
a respiratory test for helicobacteriosis helps to identify waste products of the microorganism in exhaled air;
polymerase chain reaction (molecular genetic method);
blood test for IgG antibodies. This examination is not always informative, since antibodies persist for a long time after an infection.

There are many different ways to determine this disease, but none of them is protected from diagnostic errors and cannot be considered completely reliable. Therefore, it is impossible to give preference to any particular method; it would be more correct to combine several types of research.

Diagnostics should be carried out before and after therapy for control. Monitoring of success should be carried out 4-6 weeks after the use of medications using at least two diagnostic methods.

How to treat Helicobacter pylori?

If the examination shows the presence of bacteria, you should definitely contact a gastroenterologist, because only a qualified specialist can select a treatment regimen for Helicobacter pylori.

Modern therapy for diseases associated with this bacterium is based on the severity of the disease, the phase of the process and etiological factors. The infection is eliminated only with complex, eradication treatment with antibiotics.

How to treat Helicobacter pylori? Eradication implies the complete destruction of Helicobacter pylori bacteria in any form and promotes stable remission. The combination of amoxicillin, clarithromycin and rabeprazole is considered the most successful. This is a first line circuit with three components.

In case of unsatisfactory results, it is proposed to use a four-component second-line regimen consisting of rabeprazole, bismuth subsalicylate, metronidazole and tetracycline. The duration of treatment is no more than 14 days.

In parallel with eradication therapy, probiotics (Linex, Bifiform) should be taken, which reduce adverse reactions and increase the effectiveness of treatment.

The effectiveness of therapy depends on the form of the disease, the correctness of treatment and the sensitivity of the bacteria to antibiotics. Antibacterial treatment for acute gastritis or ulcers usually leads to complete recovery without health consequences.

Chronic gastritis, accompanied by atrophic changes, is more difficult to treat, but although the atrophied areas are not restored, the risk of their degeneration into a cancerous tumor is reduced.

Treatment of Helicobacter pylori with folk remedies

The effectiveness of many traditional methods of treating Helicobacter pylori has not been tested by official medicine. Treatment agents are selected depending on the course of the disease. Heavy, spicy, fatty foods and alcoholic drinks are excluded from the diet.

Before main meals, it is recommended to take an infusion containing pear, strawberry and apple flowers, as well as lingonberry leaves. For 1 liter of boiled water you need to take 4 tbsp. raw materials (a tablespoon from each plant), leave for 30 minutes, strain and take half a glass. Tea compositions may vary.

An alcohol tincture of propolis can be used as an antimicrobial agent. Take 20 drops three times a day for 7 days.

Prevention of Helicobacter pylori

Immunity to helicobacteriosis is not developed, and the disease tends to recur. Prevention lies in maintaining personal hygiene, maintaining a healthy lifestyle, timely examination and treatment of the entire family, provided that an infection is detected in one of the relatives.

There are rules to follow:

Personal hygiene products must be individual;
You cannot use shared utensils;
you need to wash your hands before eating;
do not kiss strangers;
do not abuse alcohol;
do not smoke, either actively or passively.

There is no vaccine against the bacterium yet, but efforts are being made to create a vaccine. It was assumed that it could be taken with food, but developing a vaccine that would work in the acidic environment of the stomach proved problematic.

In addition, many people experienced diarrhea during testing of the oral vaccine. Therefore, at the moment, vaccination is a matter of the future, which needs significant improvements.

Which doctor should I contact for treatment?

If, after reading this article, you think that you have symptoms characteristic of this disease, then you should

Currently, Hp infection is one of the most widespread infections on the globe. According to some estimates, up to 50% of the population worldwide is infected with this microorganism. Most people become infected at a young age (under 20 years of age), while the infection rate in adults is about 0.5% per year. There is an inverse relationship between a person's socioeconomic status and the prevalence of Hp infection. In the USA, European countries and Oceania, about 1/3 of the population is infected, most of which are people in the older age group. In Russia, the percentage of infected people is 85%, in America among the white population - 50% and among the black population - 70%, in India - 100%. Several large epidemiological studies indicate a higher prevalence of infection in men than in women (on average 5-20%). In some developing countries, most children are infected with H. pylori by the age of 10, and by midlife the pathogen is found in almost every person.

Helicobacter pylori is a gram-negative microaerophilic bacterium that has a curved S-shaped or slightly spiral shape with 4-6 flagella, which determine the ability to move extremely quickly even in thick mucus or agar. When cultivated on artificial nutrient media, it takes the form of a rod, and during long-term cultivation, it takes a coccoid form. The length of the bacterium is 2.5-3.5 microns, width - 0.5-1.0 microns. The most favorable conditions for the existence of HP are a temperature of 37-42oC and a pH of 6-8. At lower pH values (4-6), bacteria retain their viability, but stop growing and reproducing.

The bacterium HP was discovered in 1979 by Australian pathologist Robin Warren and Barry Marshall. They were able to isolate and isolate this microorganism from samples of the human gastric mucosa, and they were also the first to cultivate this microorganism on artificial nutrient media. In the original publication, Warren and Marshall suggested that most stomach ulcers and gastritis in humans are caused by infection with the microorganism Helicobacter pylori, and not by stress or spicy foods, as previously thought. In 2005, Robin Warren and Barry Marshall were awarded the Nobel Prize in Medicine.

The source of infection caused by H. pylori is a human patient or a carrier of the bacteria. HP can be found in saliva, feces, and dental plaque. The pathogen is transmitted by oral-oral, fecal-oral, contact and household routes. The oral-oral route of transmission of infection occurs during gastric intubation and fibrogastroscopy if imperfect disinfection methods are used to sterilize endoscopes and probes. It is possible that H. pylori enters the body with a microaerosol that is formed when talking or coughing. As a rule, all family members are infected with the same strain of Hp, which proves the contact and household route of transmission.

Despite the high percentage of Hp infection in the population, the vast majority of infected individuals do not have clinical manifestations at the time of diagnosis, but they represent a risk group in which a number of diseases develop over time. Most infected individuals do not develop clinical manifestations of the disease throughout their lives.

*H. pylori infection is responsible for at least 327 thousand new cases of stomach cancer per year.

Infection with H. pylori usually occurs at a young age, but the disease usually does not develop until several decades later. During this long incubation period, the host develops an immune response to the invading pathogen. Immune responses are not able to eliminate the infection, but may be important in the development of the disease. During the life of the microbe, ammonia is formed in the stomach, protecting it from digestion by gastric juice; ammonia enters the bloodstream and spreads throughout the body, damaging almost all internal organs and causing disturbances in the functioning of the cardiovascular system, central nervous system, genitourinary and endocrine systems. In many cases, the infection may be asymptomatic. The clinical picture corresponds to the developed disease.

Indications for prescribing an analysis to detect HP are: peptic ulcer of the stomach and/or duodenum; non-ulcer dyspepsia; gastroesophageal reflux disease; atrophic gastritis; stomach cancer in close relatives; newly diagnosed Helicobacter infection in people living together or relatives; preventive screenings to identify people at risk of developing stomach ulcers or cancer; assessment of the effectiveness of eradication therapy; impossibility of performing invasive diagnostic methods (endoscopy).
Diagnosis of Helicobacter pylori infection is possible using a number of methods that make it possible to identify the microorganism itself, signs of its vital activity, or the body’s immunological response to infection (antibodies in the blood serum). As a rule, the patient is referred for research when an active inflammatory process is detected in the stomach or duodenum.
1) Detection of specific anti-Helicobacter antibody classes in the patient’s blood.
2) Breathing tests with registration of waste products (carbon dioxide, ammonia)
3) Detection of bacterial DNA by PCR in analyzes of feces, saliva, and dental plaque.
4) Detection of microorganisms during microscopic examination of a biopsy of the mucous membrane taken during FEGDS.

A gastroenterologist diagnoses and treats this infection.

Detection of Helicobacter pylori infection in the absence of inflammatory diseases of the gastrointestinal tract is not an indication for therapy. For the treatment of Helicobacter pylori infection, several therapeutic regimens have been developed, including one, two or three antibacterial drugs (amoxicillin, clarithromycin, furazolidone, etc.), antisecretory agents (omeprazole, ranitidine) and bismuth preparations.
Monitoring of eradication (destruction) of Helicobacter pylori is carried out 2-6 weeks after treatment using at least two diagnostic methods from the above.

Gastrointestinal pathologies are often caused by Helicobacter pylori infection. The disease is accompanied by nausea, pain in the epigastric region, heartburn and dangerous complications in the form of peptic ulcers, gastritis, and malignant neoplasms. At the first symptoms of helicobacteriosis, it is recommended to consult a doctor who will prescribe treatment, diet and give preventive recommendations.

How and why does pathology occur?

Helicobacter pylori is activated only in a weakened body with reduced immunity.

Helicobacter pylori infection develops due to the entry of the bacterium Helicobacter pylori into the gastrointestinal tract (GIT). Penetrating into the body, the microbe penetrates the mucous layers of the stomach and develops. To survive in the acidic environment of the organ, the microorganism is covered with a protective film and secretes an enzyme - urease, which neutralizes hydrochloric acid. In the process of life, it produces toxins, which irritate the mucous membranes of the stomach and duodenum and cause inflammation. The routes of infection as causes are as follows:

lack of personal hygiene;
contact with the saliva of a sick person;
using utensils and items that have not been sanitized;
crowding of people, among whom there is a sick person;
consumption of water and food contaminated with Helicobacter.

Smoking and drinking alcohol can be an indirect cause of Helicobacter pylori infection. The poisons contained in alcohol and nicotine weaken the protective properties of the gastrointestinal mucosa, disrupt secretion, which facilitates the life of the microorganism and promotes its reproduction.

Symptoms: how does the disease manifest itself?

Toxins provoke nausea and vomiting.

The disease is not always acute and does not make itself felt for a long time. Under the influence of unfavorable factors, the bacterium is activated and the following signs of Helicobacter pylori infection appear:

nausea or vomiting;
pain and burning in the epigastric region;
heartburn;
a feeling of heaviness in the stomach even after eating a moderate amount of food;
excessive gas formation;
stool disorder;
sour or bitter taste in the mouth;
general deterioration of condition.

What are the complications?

Helicobacter pylori infection can lead to consequences in the form of the following diseases:

Gastritis. Under the influence of microbial toxins, the lining of the stomach is irritated, which causes an inflammatory process. This disease can lead to anemia, impaired secretion and dysfunction of the mucous membranes of the organ.
Peptic ulcer disease. It is characterized by a decrease in the production of protective mucus and the level of prostaglandins, as well as suppression of the formation of new gastric epithelial cells due to Helicobacter toxins. A stomach ulcer is dangerous due to perforation, internal bleeding and death.
Duodenitis. It occurs due to the localization of bacteria in the duodenum and causes through perforation of the walls of the organ, pancreatitis, disruption of the liver and biliary tract, and bleeding.
Adenocarcinoma. A malignant formation appears due to the release of toxins by Helicobacter, which are similar in composition to carcinogens. Because of this, atrophic gastritis occurs, in which stomach cells degenerate into cancer.

How is diagnosis carried out?

Black impurities in the stool indicate the presence of bleeding.

Diagnostic measures are carried out by a gastroenterologist. The doctor finds out the nature of the pain, inquires about the patient’s diet, and performs palpation and probing of the epigastric region. An infection caused by the Helicobacter bacterium has similar symptoms to other gastrointestinal diseases. Therefore, the doctor prescribes examinations for the patient to undergo, including the following diagnostic procedures:

stool occult blood test;
blood test - general and to determine the presence of the Helicobacter bacteria;
urease test;
endoscopy;
polymerase chain reaction to detect antibodies of a microorganism;
contrast radiography of the gastrointestinal tract;
and duodenum;
CT scan.

Treatment: which methods are effective?

Drug therapy

The treatment regimen for an infection associated with Hp is drawn up by a doctor. Self-medication is dangerous. The bacterium is destroyed using antibiotic therapy. Helicobacter pylori disease is cured with the following drugs given in the table:

Drug group	Pharmaceutical product
Antibiotics	"Azithromycin"
	"Clarithromycin"
	"Tetracycline"
	"Amoxiclav"
	"Amoxicillin"
Painkillers and antispasmodics	"No-Shpa"
	"Analgin"
	"Papaverine"
	"Drotaverine"
Proton pump inhibitors	"Rabeprazole"
Proton pump inhibitors	"Omeprazole"
Reducing acidity	"Maalox"
	"Almagel"
	"Renny"
	Sodium bicarbonate
Eliminates the gag reflex	"Motilium"
Eliminates the gag reflex	"Cerucal"

Diet

Correcting your diet will speed up the healing process.

It is recommended in combination with taking medications. The consumption of alcohol, as well as fried, fatty, pickled foods rich in preservatives, hot seasonings and spices is strictly prohibited. It is recommended to eat 5-6 times a day in small portions. Food should be taken in grated or pureed form. What is allowed and prohibited for Helicobacter pylori infection is shown in the table.

Testing for Helicobacter pylori is prescribed to all patients with suspected chronic gastritis or ulcerative lesions of the stomach and duodenum. The bacterium Helicobacter pylori acts as a provoking factor for a certain group of diseases, including cancer and lymphoma of the stomach.

It is important to identify this infection in time in order to begin targeted treatment, which is highly likely to remove pathogens from the human body.

Why is it worth regularly testing for bacteria?

Infection with bacteria can occur in several ways:

Through contaminated hands (especially after visiting public places, toilets, streets).
Through household items (dishes, toothbrush), when there is an infected person in the family - with confirmed gastritis or peptic ulcer.
In children, contact transmission is often realized (through toys, etc.).
Through close contact with a sick person through aerosol transmission (sneezing, kissing).

Attention! That is why it is important to observe the rules of personal hygiene and insist that all family members follow them.

Preparing for tests

There are invasive and non-invasive (without penetration into the gastric cavity) methods for diagnosing Helicobacter pylori. Before signing up for them, you need to familiarize yourself with the general preparation rules and restrictions, and have a clear understanding of the nature of the study. For each analysis, the limitations vary slightly.

General rules for preparing for the examination:

A week before the scheduled date, you should refrain from taking medications that contain antibiotics.
The day before, you should not abuse spicy, fatty foods, opting for a light and healthy dinner.
The day before going to the doctor, it is strictly forbidden to drink alcoholic beverages or smoke. It is necessary to stop drinking strong tea and coffee.
Two weeks before the test, stop taking pills that affect intestinal activity.

When do you need to take a test to detect helicobacteriosis?

The reason for prescribing a test for H. pylori is the appearance in the patient of characteristic complaints and manifestations of stomach or duodenal disease:

Periodic pain in the stomach area. You should be especially wary of pain that goes away after eating (often this sign indicates a stomach ulcer).
The appearance of heartburn or an increase in its manifestations, an increase in the frequency of attacks.
A constant feeling of heaviness in the stomach, even after eating a small amount of food.
Sudden aversion to meat dishes, even to the point of vomiting.

Attention! The bacterium H. pylori colonizes the stomach lining of many people without causing inflammation. If its permissible concentration is exceeded, then corresponding disease complaints appear, requiring careful diagnosis and treatment.

Diagnostic methods for Helicobacter pylori

To identify pathogenic bacteria in the body, scientists have developed many diagnostic tests. A wide selection of specific studies allows you to select the most suitable one for each patient, and prescribe another type of examination if the results of the first are questionable.

Blood test for Helicobacter pylori

The study involves donating venous blood to determine the presence and titer of antibodies to Helicobacter pylori.

Rules for preparing to donate blood for Helicobacter:

On the eve of the analysis, you should refrain from fatty, spicy, and heavy foods.
An hour before donating blood, refrain from smoking.
Blood sampling is performed strictly on an empty stomach. If it is not performed in the morning, then at least 4 hours should pass after the last meal.

The study is based on an enzyme-linked immunosorbent assay (ELISA), which makes it possible to detect antibodies (class Ig G, M) to the microorganism in the patient’s blood serum. The method is not used to monitor the effectiveness of treatment, since a significant amount of antibodies circulates in the patient’s peripheral blood for about a year after eradication therapy.

Attention! Antibodies to Helicobacter pylori begin to be actively synthesized 3-4 weeks after infection, so they may not be detected immediately, giving a false negative result.

Stool analysis for Helicobacter pylori

The procedure for taking this analysis is familiar to everyone from childhood. All you have to do is bring a sample, and the laboratory assistants will do the rest.

How to prepare for a stool donation:

Three days before collecting material, stop taking medications that affect intestinal function.
Three days before the study, stop using medicinal suppositories.
In order to collect material, you need to wait for the natural act of defecation.
The feces are placed in a special sterile container with a tight-fitting lid.

The method is more productive for detecting Helicobacter pylori infection. Using monoclonal antibodies, Helicobacter antigens (protein structures located on the membrane of the pathogen) can be detected in the feces of an infected person. The technique is used for the initial diagnosis of infection and to monitor the effectiveness of treatment.

Attention! Regular stool testing helps track the dynamics of the disease; prevent and promptly begin treatment of many stomach diseases (gastritis, ulcers, tumors).

Urease (breath) analysis

The examination consists of giving the patient a special (safe for health) liquid to drink that contains a urea solution. After a short period of time, the patient is asked to make several exhalations into a tube connected to the sample collection package.

How to prepare for a breath test:

The urease breath test implies a complete abstinence from alcoholic beverages.
On the eve of the study, only a light dinner is recommended.
Stop taking anti-inflammatory medications a week before the test.
1-2 days before the examination, exclude gas-forming foods (fresh vegetables, legumes, confectionery) from the diet.
Stop smoking.

The liquid that the patient drinks is labeled with a special carbon isotope. Therefore, if there are bacteria on the wall of the stomach, they enter into a chemical reaction with urea, releasing ammonia and carbon dioxide, which the indicators of the device are aimed at.

Learn more about performing a breath test for Helicobacter in the article...

Cytological analysis

For cytological examination, the material used is special smears-imprints of biopsy tissues obtained from the most affected areas of the mucous membrane of the duodenum and stomach during FEGDS (visual assessment of the condition of the upper gastrointestinal tract using an endoscope). In the laboratory, smears are placed on a special glass, the glass is necessarily dried and stained with specific dyes (according to Papenheim, Romanovsky-Giemsa).

With this approach, the error is eliminated almost 100%, since the technique allows you to reliably detect the presence of a microorganism and roughly estimate its quantitative indicators.

Possible results of a cytological test:

negative when no bacteria were detected;
weak (+) – the number of microbial bodies does not exceed 20 in one field of view;
medium (++) – 20-40 bacteria per field of view;
high (+++) – over 40 microbial bodies.

Histological analysis

The method of implementation is similar to cytological (during FEGDS, biopsy material is taken from several areas). The pathogen is detected by microscopy, DNA hybridization or using monoclonal antibodies. In addition, the morphological state of the mucous membrane is assessed.

Molecular biological method - PCR method

The test is prescribed for the purpose of qualitatively identifying the DNA of the microorganism - Helicobacter pylori. For this purpose, biopsy samples of the duodenum, stomach, and gums are also used. PCR allows you to detect a unique strain of bacteria in the human body, evaluate their phenotypic characteristics, and develop special treatment tactics.

PCR is prescribed in the following cases:

ulcerative damage to the walls of the stomach, small intestine;
pathological morphological state of the mucous lining of the stomach;
tumors, polyps, other neoplasms in the stomach area (malignant, benign);
dysfunction of the esophagus, ulcers, erosions in its area, reflux of stomach contents back into the esophagus;
genetic predisposition to gastric cancer;
to monitor treatment and track positive dynamics towards recovery.

Normal test results

In a healthy person, with FEGDS, the mucous membrane is pale pink, without pronounced folding, erosion, or ulcerative defects; The rapid urease test shows a negative result.

The absence of Helicobacter in smears indicates a negative examination result. PCR can detect DNA fragments of microorganisms that are non-pathogenic to humans. For a respiratory urease test, a positive result is an increase in exhaled carbon dioxide (in several samples) by 5 or more ‰.

In the case of ELISA (to confirm the diagnosis), the presence of a diagnostic titer of antibodies of only the Ig M class is necessary.

For stool analysis, there are two answer options: positive (bacterial fragments are detected), negative.

There are a significant number of examinations for Helicobacter pylori, which help to quickly and effectively confirm infection, assess the condition of the internal wall of the stomach, and begin specific therapy in a timely manner.

Urease breath test for Helicobacter - description

UBT breathing tests, or urea breath tests, are completely painless and therefore convenient for the patient.

The equipment required to perform this research is no longer rare these days. Almost every major hospital has it. To do UBT, just call any paid general clinic.

Also keep in mind that such a test is usually included in the list of services of network medical institutions that specialize in performing tests - Invitro, etc.

Description of the study and instructions for the patient

Helicobacter pylori is a specific gram-negative bacteria that produces urease during its life. Urease is an enzyme that speeds up the reactions that convert urea to ammonia and carbon dioxide.

By analyzing the isotopic composition of elements in exhaled air, one can draw conclusions about the presence or absence of harmful microorganisms.

If significant urease activity is not observed, then there is reason to assume that the body is not infected.

Procedure for performing a breath test for Helicobacter

Helicotest is elementary. The patient receives a plastic tube from the doctor and places it in his mouth. It is necessary to breathe through this tube for several minutes (usually an hourglass is placed in front of the subject, by which he himself can track the time). Breathing should be calm; deep or convulsive breaths are not necessary.

Then the patient, at the specialist’s signal, takes out a tube and drinks the urea solution. It is not disgusting to drink - it is colorless and tasteless, like water.

The doctor measures the level of the indicator column. The previously described manipulations are repeated with a similar duration, then the measurement is taken again.

The only inconvenience during the diagnostic procedure may be the release of saliva. It should not get inside the tube. If you really want to swallow, the right thing to do is take out the tube for a few seconds.

The technique of this study is very good in that it allows you to quickly obtain results. If your gastritis is of bacterial origin, your doctor will tell you right away.

Preparing for the Helicobacter pylori breath test

Remember the requirements that you will have to comply with. Neglecting them can lead to false diagnostic results.

Preparing to take the helic test involves the following steps:

Two to three weeks before the day on which the procedure is to be performed, you must stop taking antacids and antibiotics;
For three days you cannot drink wine or any other alcohol;
The day before, you should not eat foods that increase gas formation - peas, beans, potatoes, brown bread, etc.;
Dinner the day before should not be too filling;
In the morning it is forbidden to have breakfast and smoke.

You should also not freshen your breath with chewing gum during the test - you are not going on a date, but for an examination. But brushing your teeth and rinsing your mouth is strictly necessary.

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The classification of methods for detecting Helicobacter pylori infection is presented in the table.

Invasive methods require an endoscopic examination (FEGDS) with a biopsy and further study of gastrobiopsy samples. Non-invasive methods of endoscopic examination do not require.

Histological method

The histological method for studying gastric biopsy samples is microscopy of gastrobiopsy smears stained in various ways (hematoxylin-eosin, Giemsa, toluidine blue, Warthin-Starry). This method allows you to determine the severity of inflammation of the coolant, the presence of atrophy, intestinal metaplasia and the presence (degree of contamination) of HP.

Rapid urease test (Helpil test)

Rapid urease test (Helpil test) - determination of HP by the urease activity of a microorganism in biopsy specimens of the coolant. Helicobacter pylori produces urease, under the influence of which urea is hydrolyzed to form ammonium ion. At the same time, the pH of the medium increases, which can be recorded by changing the color of the indicator. Gastrobioptates are placed in a solution containing urea and an indicator, the color change of which indirectly indicates the presence of HP.

Molecular genetic method - PCR in biopsy specimen

The molecular genetic method for studying gastric biopsy specimens using PCR makes it possible to isolate highly pathogenic and low-pathogenic HP strains.

Bacteriological method

It is important to carry out a bacteriological method for studying biopsy specimens of the gastric mucosa: cultural examination and determination of the sensitivity of HP to antibiotics before first-line therapy in regions with high resistance to clarithromycin (more than 15-20%), if it is planned to use standard three-component eradication therapy, one of the components of which is clarithromycin. A bacteriological method with determination of sensitivity to antibiotics should also be used if second-line eradication therapy is ineffective.

Examination of stool for the presence of HP antigen (ELISA)

ELISA (especially using monoclonal antibodies) for detecting the HP antigen in feces is a highly sensitive and specific method for both the primary diagnosis of HP infection and for monitoring the outcome of treatment.

Serological method

The serological method (ELISA) - determination of IgG antibodies to HP in blood serum - is a simple and accessible method for primary screening of infection. Considering that antibodies to HP persist for many months after eradication of the microorganism, the use of a serological method is not recommended for assessing the effectiveness of eradication therapy.

Urease breath test with 13C-urea

Urease breath test is a study of the composition of exhaled air after taking a solution of urea labeled with a carbon isotope (13C). If HP is present in the stomach of the subject, urea, under the influence of urease produced by the bacterium, undergoes hydrolysis to NH4+ and HCO3-, followed by the formation of carbon dioxide from HCO3-, which, entering the bloodstream, is then released through the lungs and can be determined by a spectrometer in the exhaled air. This test can be used both for the primary diagnosis of HP and for assessing the effectiveness of eradication.

Against the background of Helicobacter pylori infection, inflammatory diseases of the gastrointestinal tract develop, such as gastric or duodenal ulcers, erosive gastritis, and gastroduodenitis.