Helicobacter breath test

Stress, dietary errors, and increased acidity – for a long time, these factors were considered the main causes of gastritis and peptic ulcers. However, in 2005, Australian scientists Barry Marshall and Robin Warren won the Nobel Prize in Physiology or Medicine for their discovery that Helicobacter pylori plays a leading role in the etiology of gastritis and ulcers.

Helicobacter pylori is a gram-negative spiral-shaped microorganism that is able to survive in acidic conditions thanks to the “space suit” of ammonia gas that it produces. The ammonia shell surrounds the bacterium like a capsule, as a result of which Helicobacter begins to multiply freely, provoking inflammatory processes in the mucous membrane of the stomach and duodenum.

Most often, Helicobacter infection occurs in childhood. The bacterium is transmitted through saliva and mucus, and therefore you can become infected with a kiss, due to the use of common utensils and neglect of hygiene rules. In this case, the development of the disease does not necessarily occur immediately after infection. Often, the infection can lurk in the body for many years in the form of an asymptomatic carriage. Activation of Helicobacteriosis can be triggered by malfunctions of the immune system caused by stress or diseases. In addition, the abuse of hot or spicy foods, which damage the gastric mucosa, as well as alcohol and nicotine vapor, can activate the inflammatory process.

In order to establish the bacterial etiology of gastritis and peptic ulcer, it is necessary to conduct special studies.

Methods for detecting Helicobacter pylori

To date, there are several diagnostic methods that allow you to detect the presence of Helicobacter bacteria in the body. First of all, you can perform fibrogastroduodenoscopy ( FGDS). During this procedure, the doctor examines the stomach with an endoscope and captures a tiny piece of mucosal tissue – the so-called biopsy, for further histological examination. It is studied under a microscope or using a special test system to detect the presence of Helicobacter pylori. This is the so-called invasive research method.

In addition, Helicobacter infection can be detected using a blood test. The thing is that in the presence of this bacterium, the production of special antibodies, immunoglobulins, begins. They can be detected using enzyme immunoassay. It is also possible to determine the presence of a bacterium in the body using the polymerase chain reaction method to detect a DNA fragment of a bacterium in feces, such an analysis provides accurate evidence of the presence of a bacterium.

Recently, however, another method of detecting infection has been especially popular – a breath test for Helicobacter pylori. It is a fast, simple and non-traumatic procedure for the patient, characterized by high accuracy of results.

When to get tested for Helicobacter pylori

Conduct a test for the presence of Helicobacter Pylori bacteria in the body in case of any manifestations of a malfunction of the digestive system. The following symptoms should be alert:

• frequent heartburn, belching with air or food;
• feeling of discomfort, heaviness, pressure in the stomach after eating;
• nausea after eating, even in the absence of errors in the diet;
• rejection of meat food;
• suddenly manifested signs of metabolic disorders: brittle nails, increased hair loss, dryness and flaking of the skin, unexpected allergic reactions.

In addition, it is mandatory to conduct a study on Helicobacter pylori if this infection was detected in one of your family members, as well as in diseases such as gastritis, peptic ulcer, gastroduodenitis. Only after the diagnosis is made, the doctor can prescribe a treatment that will prevent the development of severe complications caused by Helicobacter infection. Please note that it is impossible to delay therapy, since the lack of therapy can lead to the appearance of complications of diseases provoked by this bacterium, namely gastric bleeding, perforation and penetration of the ulcer, as well as malignant degeneration of erosions and ulcers.

Advantages and disadvantages of the breath test

The so-called respiratory (or respiratory) test for Helicobacter pylori is absolutely safe and non-invasive, which is important for patients with increased lability of the nervous system. In addition, the result of the study will be ready fairly quickly. And the most important advantage of a respiratory study is its high accuracy. The reliability of the results is 90-95%.

At the same time, there are no contraindications for this research method. However, it should be borne in mind that a reliable breath test for Helicobacter will only be subject to proper preparation for it.

How to prepare for the study

In order for the result of a breath test for the presence of Helicobacter Pylori in the body to be reliable, a number of rules must be observed.

• the study should be carried out exclusively in the morning, on an empty stomach. Please note that on the eve of the planned diagnosis, the stomach should not be overloaded, dinner should be very light;
• if you are very thirsty, then no later than one hour before the test, you can drink no more than 100 ml of water;
• the use of alcohol should be abandoned three days before the study;
• the day before the test, exclude legumes from the diet;
• do not smoke for four hours before the study;
• just before the test, brush your teeth and rinse your mouth thoroughly;
• the use of certain medications for the treatment of gastrointestinal disease should be stopped before the study for 2-4 weeks, and the intake of antacids for 2 days.

Types and principle of the breath test

As noted above, the breath test is absolutely safe. It is widely used by gastroenterologists and therapists to conduct primary diagnostics, as well as to monitor the effectiveness of treatment.

The principle of the breath test is based on the detection of Helicobacter Pylori waste products in the air exhaled by patients. There are two main methods of the breath test. They differ in the component that is used for the reaction.

C-urea breath test

The essence of this research method is based on the ability of the Helicobacter bacterium to produce a special enzyme – urease, which accelerates the hydrolysis of urea. This process is accompanied by the production of carbon dioxide and ammonia. People who are not infected with Helicobacter pylori do not have urease in the stomach.

To detect the presence of urease, the subject takes a special reagent. This is a capsule that contains 75 mg of urea labeled with either radioactive or non-radioactive carbon (C14 or C13). In the event that Helicobacter is present in the patient’s body, after taking the reagent, hydrolysis or decomposition of urea will begin to occur, and after half an hour the patient begins to exhale vapors of ammonia and carbon dioxide, the presence of which will be recorded by a special device. In this case, the test is positive. If the bacterium is absent in the body, then ammonia vapors and carbon dioxide vapors in the exhaled air will be absent – the test will be negative.

The duration of the test, as a rule, does not exceed forty minutes. At the same time, subject to careful preparation for the analysis, its reliability is more than 95%. Remarkably, the C14 radioactive carbon test is as safe as the non-radioactive C13 test.

Breath Helic Test

This method of detecting Helicobacter is also based on the ability of this bacterium to produce urease. This method differs from the C-urease test in that a solution containing 0,5 g of carbamide is used. The bacterium is capable of provoking the hydrolysis of this substance, as a result of which the quantitative content of ammonia vapor in the air exhaled by the patient increases.

Their presence is fixed with the help of a special indicator tube (in this case, the color of the indicator changes) or with a digital device.

It should be taken into account that the Helik test is less expensive, but at the same time less informative than the C-urease test. Its reliability does not exceed 75%.

How the research is done

The indisputable advantage of both types of breath test is their non-invasiveness and comparative ease of implementation. They can be carried out both in a hospital and in a clinic.

Carrying out a C-urea breath test

Before starting the test, the patient is offered to drink 200 ml of orange juice (in case of an allergy to oranges, apple juice can be replaced). Then the patient is seated on a couch or chair and asked to hold his breath for a few seconds. After that, you need to exhale into a special bag. Care must be taken to ensure that saliva does not get there.

The bag is immediately hermetically sealed, after which the patient drinks a weak solution of urea, labeled with carbon isotopes C13 or C14. In order for the accepted reagent to spread through the gastric mucosa, the patient is often asked to lie on the couch and turn first on one side, and then lie on the other.

After about half an hour, the patient is again asked to exhale into a special bag.

When using urea labeled with C14, air is taken once, and if urea with C14 is used, then exhaled air is taken twice, with a ten-minute interval.

The finished samples are sealed, labeled and sent to the laboratory, where they are examined using a spectroscopic or spectrophotometric method. In the event that the air exhaled after taking urea contains hydrocarbon vapors, this indicates infection with Helicobacter Pylori.

Carrying out a Helic test

To conduct the Helik test, the patient takes a sitting position, a tube with an indicator is placed in the oral cavity of the subject, which is connected to a special digital device. The patient breathes into the tube for 7 minutes. The results are recorded by the doctor. It is necessary to breathe normally, without “convulsive” breaths and exhalations. At the same time, it is important that the mouthpiece does not touch either the tongue or the palate, since the smallest amount of saliva entering the tube can distort the results. In the event that saliva still gets into the indicator, the study must be started anew no earlier than in half an hour. Doctors recommend, if you really want to swallow, remove the mouthpiece from your mouth for a few seconds.

At the doctor’s signal, the patient takes 0,5 g of urea dissolved in 50 ml of water. This solution is colorless and devoid of taste, so that no discomfort occurs when it is taken.

After this, the patient is again asked to breathe into the tube for six minutes and the results are recorded. Then the patient once again takes the solution and repeated studies are carried out.

Since no analysis materials are delivered to the laboratory, and the data are recorded by a specialist directly at the site of the study, the results of the Helik test can be obtained very quickly.

Deciphering the results of the analysis and indicators of the norm

Deciphering the results of respiratory tests for Helicobacter is carried out by specialists.

So, when evaluating the data of the C-urease test, the difference between the first and second samples of exhaled air is analyzed. If it is less than 0,3 ppm, then the test is considered negative – in other words, the patient is not infected with the bacterium. The higher rate is cause for concern. Moreover, the higher its value, the more serious the degree of infection with Helicobacter pylori.

So, an indicator from 1 to 3,5 indicates the presence of bacteria in the body in the so-called inactive phase. It is at this stage that the treatment will be most effective. An indicator from 3,5 to 6,5 is considered average. Results from 6,5 to 9,5 indicate severe infection, and from 9,5 to 15 – very severe, in which treatment will be very long and difficult.

When evaluating the results of the helic test, the doctor either visually evaluates the data using an indicator tube (the indicator composition changes color), or using a special digital apparatus that records the data automatically. Thus, depending on the system used for the test, the results can be obtained either instantly or after about half an hour after the study. Please note that quantitative results cannot be obtained using this breath test – it can only confirm the fact of infection with Helicobacter or its absence.

In the event that the results of a breath test for Helicobacter indicate the presence of an infection, a visit to the doctor should not be delayed. Based on the test results and clinical results, a therapy is proposed that is designed to destroy bacteria and restore digestion. After 1-1,5 months after the end of treatment, a second breath test can be performed to check the effectiveness of the therapy used.

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