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H. Pylori Testing and Treatment

Testing

There is no definitive test for H. pylori infection. If you show signs and symptoms of infection, your doctor may test for the bacteria in several ways:

Fecal (stool) sample
This test positively predicts infection 98 percent of the time and can be used both pre-treatment and post-treatment.
Breath test
By ingesting a testing meal that contains a small amount of urea, measuring your exhaled breath may show urease activity and confirm infection. This test works best post-treatment in patients over 6 years old.
Blood test
This test is useful for detecting new infections but is not the best follow-up test for treated patients.

Treatment

The goals of treatment are to eradicate the bacteria and prevent future complications. Triple therapy is considered the best standard treatment. This therapy combines a proton pump inhibitor drug to reduce stomach acid production with two antibiotics to clear the bacteria. Typically, amoxicillin, clarithromycin, and a proton pump inhibitor are given for 2 weeks. The antibiotic metronidazole is also used in H. pylori treatment. This treatment is effective in 85 to 90 percent of adults.

Quadruple therapy, which includes the addition of fourth drug, is used as a second-line of treatment. Unsuccessful treatment usually results from patients not taking the prescribed medications properly, and recurrence in more likely in children. H. pylori reinfection rates are generally low.

Diet

Foods such as berry juice and some dairy products may have a modest effect in limiting the growth of H. pylori bacteria, though more research is needed to determine the link between diet and H. pylori treatment. Vitamin C and bismuth (the active ingredient in Pepto-Bismol) may also help in treatment.

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