What are the diagnostic methods for *Helicobacter pylori* infection?

Helicobacter pylori (H. pylori) is a carcinogenic bacterium. Upon entering the human body, it initially triggers gastrointestinal diseases; if treatment is ineffective or prognosis is poor, it may ultimately lead to cancer. Therefore, when H. pylori infection is suspected, timely diagnostic testing is essential to confirm infection and initiate appropriate therapy. Consequently, diagnostic methods are of great concern to many patients. So, what are the available tests for detecting H. pylori? Let’s take a closer look.

What Are the Diagnostic Methods for Helicobacter pylori?

1. Serological Testing (Blood Sample Analysis):

This method involves drawing a blood sample to measure serum antibody levels against H. pylori. Following infection, the human body produces specific antibodies, resulting in a positive test result. However, seroconversion typically takes several months—thus, during early infection, this test often yields false-negative results, potentially delaying optimal treatment initiation. Moreover, even after successful eradication of H. pylori, antibody titers decline slowly; patients may require 1–2 years before seroreversion occurs. As a result, cured individuals may unnecessarily undergo prolonged additional treatment due to persistently positive serology.

2. Endoscopic Biopsy-Based Testing:

When a patient undergoes upper gastrointestinal endoscopy, biopsy specimens can be collected simultaneously for microscopic examination to detect H. pylori. A positive finding confirms active H. pylori infection. To guide optimal therapeutic strategies, bacterial culture and antimicrobial susceptibility testing may also be performed. Additionally, polymerase chain reaction (PCR) analysis of biopsy samples offers high sensitivity and reliability. Alternatively, rapid urease testing (RUT) may be employed—this method is simple and fast, yet its accuracy may be compromised by insufficient observation time or other confounding factors.

3. Urea Breath Test (UBT):

The urea breath test exhibits high sensitivity, detection rate, and diagnostic accuracy, and causes no discomfort to patients. It has become one of the most widely accepted noninvasive methods for diagnosing H. pylori infection in recent years. Two main variants exist: the ¹⁴C-urea breath test and the ¹³C-urea breath test. Because the ¹⁴C test involves low-dose radiation exposure, it should be used cautiously—or avoided altogether—in children, pregnant or lactating women, and elderly or frail individuals. Repeated use of this test in the same patient is also discouraged. In contrast, the ¹³C-urea breath test is radiation-free, safe for all age groups, and demonstrates even higher detection and concordance rates.

The above outlines the major diagnostic methods for Helicobacter pylori infection. We hope this information proves helpful to you.