Does the breath test for Helicobacter pylori require fasting?

Written by Si Li Li
Gastroenterology
Updated on November 15, 2024
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Currently, the detection of Helicobacter pylori is highly accurate and specific, and a rapid, simple, and effective method is the Carbon-14 breath test.

The Carbon-14 breath test requires no eating within six hours, so it is best to take it on an empty stomach. Therefore, it is preferable to test for Helicobacter pylori on an empty stomach. Currently, the infection rate of Helicobacter pylori in our country has exceeded 50%. Helicobacter pylori is the principal cause of chronic gastritis, peptic ulcers, or gastric cancer. Therefore, if symptoms of the digestive system occur, such as belching, acid reflux, upper abdominal pain, nausea, and poor appetite, it is advisable to conduct a test for Helicobacter pylori, specifically the Carbon-14 breath test, to confirm the infection of Helicobacter pylori.

Other Voices

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Written by Jiang Guo Ming
Gastroenterology
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Do normal people have Helicobacter pylori?

In my understanding, a “normal person” refers to individuals who do not experience any stomach discomfort. In our country, the infection rate of Helicobacter pylori is extremely high, with reports indicating that over 50% of adults are infected, albeit asymptomatically. Thus, it is certain that many so-called "normal people" are infected with Helicobacter pylori, also known as asymptomatic Helicobacter pylori carriers. This condition also requires antibacterial treatment because there is a close relationship between Helicobacter pylori and gastritis, ulcers, and gastric cancer. Even for patients with chronic superficial gastritis, if Helicobacter pylori is present, eradication therapy is advocated. If not completely eradicated, it often leads to the development of chronic atrophic gastritis, which is a more serious condition.

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Written by Yang Chun Guang
Gastroenterology
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Is a gastroscopy examination accurate for detecting Helicobacter pylori?

Gastroscope testing for Helicobacter pylori is conducted under a gastroscope and is quite accurate. However, nowadays, if one is only testing for Helicobacter pylori, it generally does not require an endoscopic examination, since undergoing a gastroscope is an uncomfortable process that can cause nausea. Currently, Helicobacter pylori can be detected using a breath test method involving carbon-13 or carbon-14. This involves swallowing a capsule and then performing a breath test. It is crucial to fast before the test, as eating can affect the accuracy of the results. Therefore, although gastroscope testing for Helicobacter pylori is accurate, it is less commonly used nowadays.

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Written by Si Li Li
Gastroenterology
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Is Helicobacter pylori three pluses serious?

Three pluses for Helicobacter pylori indicate that there is an infection with Helicobacter pylori, and the level of infection is not low. Helicobacter pylori is the main cause of chronic gastritis, peptic ulcers, and even stomach cancer. If a person tests positive for Helicobacter pylori infection, and has symptoms or diseases related to the digestive system, or has a family history of stomach cancer, eradication treatment for Helicobacter pylori is necessary. The treatment involves a proton pump inhibitor plus two types of antibiotics, along with a bismuth agent, for a total of 14 days. After stopping the medication for one month, a carbon-14 breath test should be re-conducted. If the result turns negative, it means that the eradication treatment for Helicobacter pylori was successful. If it does not turn negative, remedial treatment is required.

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Written by Yang Chun Guang
Gastroenterology
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Can a gastroscopy detect Helicobacter pylori?

The examination with a gastroscope mainly focuses on checking for any damage to the mucous membranes of the stomach and esophagus. It can detect gastritis, gastric ulcers, or stomach cancer. For some patients who might have a tendency toward cancerous changes, a pathological examination can be conducted. However, testing for Helicobacter pylori with a gastroscope requires a separate lab test. Therefore, routine gastroscopic examinations generally do not include testing for Helicobacter pylori. If testing for Helicobacter pylori is needed, it is a separate examination item. Nowadays, since undergoing a gastroscopy can be quite uncomfortable and cause symptoms like nausea for some people, testing for Helicobacter pylori is accurately conducted using a breath test.

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Written by Huang Ya Juan
Gastroenterology
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How to eradicate Helicobacter pylori

The spontaneous clearance rate of Helicobacter pylori infection is extremely low, meaning that it is almost impossible to cure itself. If not treated medically, it may lead to a lifelong infection. Currently, the consensus both domestically and internationally on handling Helicobacter pylori is that eradication requires combination therapy with multiple drugs, categorized into triple therapy and quadruple therapy, with a treatment duration of 2 weeks. Triple therapy consists of a proton pump inhibitor (PPI) plus two antibiotics. We currently use quadruple therapy, which includes two antibiotics, a gastric mucosal protectant, and a proton pump inhibitor. The choice of these drugs is complex. Common anti-inflammatory drugs include amoxicillin, clarithromycin, metronidazole, and levofloxacin; in cases of bacterial resistance, we recommend using furazolidone or tetracycline. Specific medications should be consulted in detail with a doctor. After the treatment course, we need to assess whether the eradication was successful, with a re-examination one month after stopping the drugs. After the eradication of Helicobacter pylori, the rate of reinfection in adults is very low, but the reinfection rate in children is somewhat higher than in adults. Not everyone infected with Helicobacter pylori needs eradication; it is necessary only for those with ulcers, erosion, atrophy, or related symptoms.