Helicobacter pylori is a gram-negative, spiral-shaped bacterium that can infect areas of the duodenal mucosa and stomach and thereby provoke the development of gastritis, ulcers, duodenitis, cancers and lymphomas. But infection with this bacterium does not always cause the listed diseases. In 90% of cases, the carriage of Helicobacter does not cause any pathology.
Helicobacteriosis symptoms
Frequent pains on an empty stomach, which disappear after eating, may indicate the presence of a stomach or duodenal ulcer, and, consequently, infection with Helicobacter pylori. Pain in the epigastric region may disturb 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 indicate 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 digestedbad.
What studies confirm the presence of Helicobacter pylori in the body?
There are several methods for determining the presence of this infection in the body.
- Blood test for antibodies to Helicobacter bacteria.
- Study of feces for pathogen antigen.
- Breath test is not Helicobacter.
- Cytological examination of the material obtained with fibrogastroduodenoscopy (FGDS).
As a rule, the diagnosis is made only after two tests for Helicobacter pylori were positive. To date, the most reliable and effective method for detecting this pathogen is the study of material obtained during 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 do a breath test for Helicobacter pylori. It is carried out quite easily and has no undesirable consequences.
Urea breath test for Helicobacter pylori
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 splitting effect on urea. In the intestines, under the influence of urease secreted by bacteria, it is split into components - ammonia and carbon dioxide, which is released by the lungs during breathing. Hisconcentration and assessed by performing a breath test for Helicobacter pylori. The concentration of carbon dioxide is determined before and after taking urea by the patient in several samples.
Indications
Patients are advised to take a breath test for Helicobacter in the following cases:
- If there is a history of gastric or duodenal ulcer.
- If you suspect gastritis, duodenal ulcer or stomach ulcer.
- If the patient has complaints of heaviness and pain in the epigastrium, belching or heartburn.
- For non-ulcer dyspepsia.
- To control ongoing therapy for this infection.
How to prepare for the study?
In order for doctors to correctly assess the breath test for Helicobacter pylori, you need to prepare for it. Otherwise, the results of the analysis may give incorrect information. With some medications, it may take up to three weeks to prepare the patient for this test.
- Three weeks before the study, you must stop taking antibiotics, bismuth preparations and antacids - these are drugs that reduce the acidity of gastric juice.
- Three days before the study, it is forbidden to take any alcoholic beverages.
- One day before the analysis, you should not eat foods that increase gas formation (legumes, cabbage, black bread, potatoes, etc.).
- Dinner the night before should be light and not too late.
- On the morning of the study, breakfast andsmoke.
In the morning you only need to brush your teeth - this is a must, but it is forbidden to freshen your breath with chewing gum. If you are very thirsty in the morning, you can take a couple of sips of pure boiled water, but no later than an hour before the study.
A false-positive test can be provoked by a gastric resection or achlorhydria, a condition in which hydrochloric acid is completely absent in the gastric juice (it is not produced by gastric cells).
How is a Helicobacter breath test performed?
First, the he alth worker asks 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 breath samples are taken.
Next, the patient is offered to drink a 5% solution of carbamide. After 5 minutes, a sample of exhaled air is taken by turning the indicator tube over with the other end. Thus, three more samples are taken. The increase in the concentration of ammonia in the air exhaled by the patient is estimated.
If the ammonia concentration exceeds 0.5 mg/ml, the test for Helicobacter pylori respiratory is considered positive.
The procedure does not cause any negative sensations. Inconvenience can deliver only secreted saliva. For a correct assessment of the result, it should not fall into the tube, otherwise the test may be damaged. If it is not possible to swallow it, then periodically it is allowed to take short breaks and remove the tube. After swallowing saliva, the studycontinues. If, nevertheless, saliva got into the indicator tube and the test did not work out, it can be repeated after 50-60 minutes.
How to choose a laboratory?
Modern test systems are automated, and the test is assessed not by a person, but by a device. In addition, there are systems whose indicator tubes are protected from saliva ingress. This makes the procedure more comfortable. And the study itself takes less time.
Before you choose the laboratory where you are going to do a breath test for Helicobacter, you should find out what method is used for this and what equipment will be used for the study.
The cost of the test can be quite high. It depends on the comfort for the patient and the accuracy of the study. Hardware studies are more accurate.
How to evaluate the results?
So, passed the breath test for Helicobacter. The results are in. How to evaluate them? The evaluation of this study can be qualitative and quantitative.
Qualitative reaction is positive when the urease activity of these bacteria is detected, and negative if it could not be detected.
Quantitative results of the study are obtained using a special apparatus called a mass spectrometer. The result is evaluated as a percentage. These numbers show the percentage of stabilized isotope in the air exhaled by the patient, which can be used to assess the degreeinfection of the gastric mucosa with Helicobacter pylori bacteria. In total, there are four degrees of infection:
- Easy - 1 to 3.4%.
- Average - 3.5 to 6.4%.
- Heavy - 6.4 to 9.5%.
- Extremely severe - over 9.5%.
What is the norm when evaluating the results of such a study as a breath test for Helicobacter? It is considered such an indicator when only traces of labeled carbon dioxide are detected in the 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 a breath test for Helicobacter pylori gave a positive result, as a rule, additional studies are prescribed that can confirm the presence of this bacterium in the patient's body. This may be a stool 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.
