H Pylori

Helicobacter pylori (H. pylori) is a common stomach bacterium linked to gastritispeptic ulcers, and a higher risk of gastric cancer in some people. Because heartburn, stomach pain, nausea, and bloating can have many causes, lab testing is the most reliable way to confirm or rule out H. pylori.

A proactive approach uses noninvasive tests—the urea breath test (UBT) or stool antigen test—for screeningdiagnosis, and test-of-cure after treatment. Proper timing matters: certain medicines temporarily suppress H. pylori and can cause false-negative results. Blood antibody (IgG) tests show past exposure but do not prove active infection and are not recommended for test-of-cure. Use these labs alongside your clinician’s evaluation and, when indicated, endoscopy.

Signs, Symptoms & Related Situations

  • Upper-GI symptoms: burning or gnawing epigastric pain, nausea, early fullness, bloating, frequent belching

  • Ulcer clues: night pain, relief with food/antacids, anemia history

  • Complications: unexplained iron-deficiency anemia; gastric MALT lymphoma; history of peptic ulcer or upper-GI bleed (clinical management required)

  • Risk context: family history of gastric cancer, residence in or travel from higher-prevalence regions, household exposure

  • When to seek urgent care: vomiting blood, black or tarry stools, severe or worsening abdominal pain, persistent vomiting, fainting, or signs of shock

Symptoms always require clinician evaluation.

Why These Tests Matter

What testing can do

  • Confirm active infection with high-accuracy noninvasive tests (UBT or stool antigen)

  • Guide treatment decisions and verify eradication with a required test-of-cure after therapy

  • Reduce unnecessary procedures when results are clear and symptoms are uncomplicated

What testing cannot do

  • Diagnose the cause of alarm features (bleeding, weight loss)—those need urgent clinical evaluation and often endoscopy

  • Provide treatment or dosing advice

  • Give reliable results if performed too soon after PPIs, antibiotics, or bismuth (hold times needed)

What These Tests Measure (at a glance)

  • Urea Breath Test (UBT, ^13C): detects urease activity specific to H. pylori by measuring labeled carbon dioxide in breath after drinking a urea solution.

    • Best use: initial diagnosis and test-of-cure.

    • Caveats: avoid PPIs for ~2 weeksantibiotics/bismuth for ~4 weeks before testing (unless your clinician advises otherwise). Fast per kit instructions.

  • Stool Antigen (laboratory EIA/CLIA): detects H. pylori antigen in stool.

    • Best use: initial diagnosis and test-of-cure.

    • Caveats: similar medication hold times; no fasting; follow sample-collection steps carefully.

  • Serology (H. pylori IgG): shows past exposurenot recommended for active diagnosis or test-of-cure.

  • Endoscopic tests (clinician-directed): rapid urease testhistologyculture/PCR when endoscopy is indicated (e.g., alarm signs, refractory disease).

Quick Build Guide

Clinical goal Start with Add if needed
Initial diagnosis (no alarm signs) Urea Breath Test or Stool Antigen Repeat with the other method if results conflict
Test-of-cure after therapy Urea Breath Test or Stool Antigen Perform ≥4 weeks after antibiotics and ≥2 weeks off PPIs
Prior false negative while on PPIs Stool Antigen or UBT Re-test after appropriate medication holds
Endoscopy planned/required Rapid urease, histology, culture/PCR (clinic)

How the Testing Process Works

  1. Pick the test: most adults choose UBT or stool antigen for both diagnosis and test-of-cure.

  2. Prepare for accuracy: hold PPIs ~2 weeks and antibiotics/bismuth ~4 weeks before testing, if safe for you; ask your clinician about allowed symptom relief (e.g., antacids or H2 blockers).

  3. Provide the sample: breath collection in-office for UBT; at-home or in-lab collection for stool antigen (follow the kit carefully).

  4. Get results securely: most results post within a few days.

  5. Plan next steps: positive results prompt clinician-directed treatment; after therapy, repeat testing to confirm eradication.

Interpreting Results (General Guidance)

  • Positive UBT or stool antigen: active H. pylori infection—discuss treatment options with your clinician.

  • Negative UBT or stool antigen: makes active infection unlikely, but recent PPI/antibiotic/bismuth use can cause false negatives; retest after holds if suspicion remains.

  • Serology positive, active tests negative: suggests past exposure or treated infection—serology should not be used for cure confirmation.

  • Test-of-cure: perform ≥4 weeks after finishing antibiotics and ≥2 weeks off PPIs for reliable results.

Choosing Panels vs. Individual Tests

  • Single best start: UBT or stool antigen (choose one).

  • For confirmation or special settings: use the alternate noninvasive method if results are discordant or if medications could not be held.

  • Endoscopic pathway: reserved for alarm features, refractory symptoms, or clinician-planned procedures.

FAQs

Which is better—breath test or stool test?
Both are highly accurate for active infection and test-of-cure. Choose based on convenience and your clinician’s preference.

How long should I wait after treatment to re-test?
At least 4 weeks after antibiotics and 2 weeks off PPIs to avoid false negatives.

Do I need to fast?
Follow your order. UBT often requires brief fasting; stool antigen does not.

Can I test while taking PPIs?
PPIs can suppress H. pylori and cause false negatives. Hold ~2 weeks if your clinician says it’s safe.

Is an antibody (blood) test useful?
Not for active infection or test-of-cure. It detects past exposure and often stays positive for years.

What if I have black stools or vomit blood?
Seek urgent care. Bleeding is an emergency and needs clinician evaluation.

Do family members need testing?
Household transmission can occur. Testing is generally for symptomatic people or those with specific indications—ask your clinician.

Related Categories & Key Tests

  • Infectious Disease Tests Hub

  • Digestive Health • Peptic Ulcer • Gastritis & Upper GI • Liver Function Tests • Iron Deficiency Anemia

  • Key Tests: H. pylori Urea Breath Test • H. pylori Stool Antigen (EIA/CLIA) • H. pylori IgG (serology—exposure only) • Rapid Urease Test (endoscopic) • Histology/Culture/PCR (clinical)

References

  • American College of Gastroenterology — Clinical guideline on H. pylori testing and management.
  • American Gastroenterological Association — Best practice advice on noninvasive H. pylori testing and test-of-cure.
  • Maastricht/Florence Consensus Reports — H. pylori diagnosis recommendations.
  • World Gastroenterology Organisation — H. pylori guideline summary.
  • Clinical reviews on medication hold times (PPI, antibiotics, bismuth) and test performance characteristics.
  • H. Pylori and Helicobacter Pylori Lab Testing - What You Need to Know

Available Tests & Panels

Your H. pylori Tests menu is pre-populated in the Ulta Lab Tests system. Select Urea Breath Test or Stool Antigen for diagnosis and test-of-cure, follow PPI/antibiotic/bismuth hold times, and review results with your clinician to plan treatment and follow-up.

 

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The Helicobacter pylori Urea Breath Test detects H. pylori infection, a common cause of ulcers and gastritis. After drinking a urea solution, breath samples are analyzed for carbon dioxide changes caused by the bacteria. A positive result indicates active infection, while a negative shows no evidence of H. pylori. Doctors use this noninvasive test to diagnose infection, confirm eradication after treatment, and monitor gastrointestinal health.

Varied
Phlebotomist
Also Known As: H Pylori Breath Test

The Helicobacter pylori Antigen Stool Test detects H. pylori proteins in stool to diagnose active infection. H. pylori is a common cause of gastritis, ulcers, and increased stomach cancer risk. Doctors order this test for patients with abdominal pain, nausea, bloating, or indigestion. Noninvasive and accurate, results confirm active infection and are also used to monitor treatment effectiveness and eradication of H. pylori bacteria.

Stool
Stool Collection
Also Known As: H Pylori Stool Test

The Fecal Globin by Immunochemistry Test detects hidden (occult) blood in stool using antibodies that identify human globin protein. This test helps screen for colorectal cancer, polyps, ulcers, and gastrointestinal bleeding. Doctors order it when patients have anemia, abdominal pain, or changes in bowel habits. Results provide early detection of digestive tract bleeding, guiding further evaluation with colonoscopy or other diagnostic procedures.

Varied
Phlebotomist
Also Known As: Fecal Immunochemical Test, Fecal Occult Blood Test, Stool Occult Blood Test, FIT Test, FOBT

Most Popular

The Gastrin Test measures gastrin hormone levels in blood, which regulate stomach acid production. Elevated levels may indicate Zollinger-Ellison syndrome, gastrinoma, pernicious anemia, or chronic atrophic gastritis. Doctors order this test for patients with recurrent ulcers, abdominal pain, or unexplained diarrhea. Results help evaluate abnormal acid production, detect tumors, and guide treatment for gastrointestinal and metabolic conditions.

Blood
Blood Draw
Also Known As: Gastrinomas Test

Helicobacter pylori, or H. pylori, is an extremely common bacteria that infects the majority of the world's population. By many estimates, approximately 60 percent of adults worldwide carry H. pylori in their stomachs. Some people never experience any symptoms from the infection, but others can develop stomach ulcers, inflammation, and even stomach cancer.

It might be a bit unsettling or even frightening to realize that you might have been carrying a potentially harmful bacteria for much of your life. This could be even more true if you have recently developed peptic ulcer disease or are experiencing other uncomfortable digestive symptoms.

The good news, however, is that there are simple, effective H. pylori tests that can help you make informed decisions about your health. Once you have been screened for H. pylori, you and your doctor can diagnose, monitor, and treat your condition. 

Read on for more information about H. pylori infection, signs and symptoms, and how to screen for, diagnose, and monitor the condition.

About H. Pylori

H. pylori is a common bacteria that lives in the digestive tract. It can infect your stomach lining for years or decades before you develop complications, which can make it very difficult to know whether you've been infected with H. pylori without proper testing. In fact, some people never experience any symptoms from their infection.

Other people, however, can develop gastritis (inflammation of the stomach lining), peptic ulcer disease, or even gastric cancer. This happens when the bacteria damage the lining of the stomach enough that stomach acid begins to cause ulcers, bleeding, and other problems.

Risk Factors for H. Pylori

There are many risk factors for H. pylori infection. Many people pick up the bacteria as children but don't show symptoms for years. Living conditions in childhood can increase your risk for contracting H. pylori.

Living in crowded conditions, lacking reliable access to clean water, living in a developing country, and/or sharing housing with someone who is infected can greatly increase your risk of contracting H. pylori as a child.

Causes of H. Pylori

You can get H. pylori in many ways, including through food, water, and eating utensils. You can also get H. pylori directly from someone who is infected via saliva, vomit, or other bodily fluids.

Doctors don't fully understand why some people who are infected with H. pylori never develop any complications, and why others contract ulcers or even stomach cancer. This means that a laboratory test can be especially helpful as you monitor your own symptoms.

Signs and Symptoms of H. Pylori

Ulcers can cause extreme discomfort and pain and can damage the lining of your stomach. Some common symptoms of ulcers are:

  • Gnawing or burning pain in your abdomen, especially between meals
  • Pain that improves temporarily when you eat, drink milk, or take an antacid
  • Nausea or vomiting
  • Bloating
  • Gas or frequent burping
  • Unexpected weight loss
  • Loss of appetite
  • Heartburn

When to See Your Doctor Immediately

Sometimes, ulcers can cause internal bleeding, which can be very dangerous. See your doctor right away if you experience:

  • Bloody, dark red, or black stool
  • Bloody or black vomit, or vomit that looks like coffee grounds
  • Severe, repeated stomach pain
  • Trouble breathing or difficulty swallowing

The symptoms of stomach cancer are difficult to identify at first, and you may experience heartburn or another discomfort that could be mistaken for side effects of ulcers. You may also experience:

  • Swelling and pain in the belly
  • Consistent nausea and loss of appetite
  • Trouble eating more than small amounts
  • Unexpected weight loss
  • Vomiting

Since these symptoms can easily be mistaken for other gastrointestinal issues, it is very important to test and monitor for Helicobacter pylori infection and discuss your treatment with your doctor.

Lab Tests for H. Pylori

Fortunately, there are several effective H. pylori tests that can help you take charge of your health. The most common tests are stool tests and breath tests. Sometimes a doctor may order a scope test, but this is typically for more advanced symptoms or as a follow-up to determine the best treatment options.

Stool Tests

stool antigen test looks for foreign proteins associated with H. pylori in your stool. Accurate, straightforward stool tests can be ordered directly from the lab; there are just a few things you should know ahead of time.

Many common medications can occasionally interfere with the accuracy of these tests. You are not necessarily required to stop taking medication for your tests from Ulta Lab Tests. However, in the event of a negative result, your doctor may recommend that you stop taking antibiotics and proton pump inhibitors (PPIs) for two weeks before a follow-up test.

Breath Tests

The urea breath test is a simple, non-invasive, non-radioactive test with highly accurate results. You simply swallow a pill, liquid, or pudding that contains urea. You'll then breathe into a bag. H. pylori will change the substance into carbon dioxide, so if you have it, the test results will show higher levels of carbon dioxide than normal.

For the greatest accuracy, you should stop taking antibiotics, PPIs, and bismuth preparations (such as Pepto-Bismol) two weeks before the test.

FAQ

Looking for even more information? Here are some of the most frequently asked questions about these tests.

Which Test Is Better for Me?

All tests at Ulta Lab Tests are highly accurate, with patient-friendly processes. The stool test requires self-collection at home before dropping it off at a collection center. The urea breath test is done quickly at a patient service center but has more stringent requirements on medication use ahead of time. 

How Quickly Will I Get My Results?

It can vary. However, your results are typically available online after just 1-2 business days.

Is My Information Secure?

Absolutely. Your results are private and secure, and your information is carefully safeguarded. No one else will see your results unless we are required to release them by law.

What if I Don't Have Insurance?

Insurance is not required for our tests. Our pricing is affordable to everyone.

What Are My Treatment Options for H. Pylori?

H. pylori is typically treated with a combination of two different antibiotics, which prevents the bacteria from becoming fully resistant to one of them. You may also return to taking PPIs and bismuth preparations. Your doctor will typically order a second test after four weeks to see if treatment was effective.

Schedule H. Pylori Tests

There are many benefits to taking advantage of available H. pylori tests through Ulta Lab Tests. Knowing your results can allow you to take control of your health, and to go into a doctor's appointment fully prepared and informed.

If you are suffering from ulcers or gastrointestinal distress, finding out whether you have H. pylori can help you treat the infection. This can prevent further damage to the stomach lining, which in addition to pain and discomfort could eventually lead to internal bleeding or even stomach cancer.

Take control of your health now by booking your Ulta Lab Test for H. pylori.