Helicobacter pylori (qualitative)

Helicobacter pylori is a bacterium that can live in the stomach lining, often from childhood. The bacterium can cause long-lasting inflammation of the stomach or of the first part of the small intestine. This test detects fragments of the bacterium (antigens) in a stool sample. A positive result means that the bacterium is present in the stomach at this moment.

• Infection with Helicobacter pylori, the stomach bacterium
• One of the causes of a stomach ulcer or an ulcer in the first part of the small intestine
• Checking whether the bacterium is gone after treatment

• Stop acid reducers such as omeprazole or pantoprazole 2 weeks beforehand. Check with your doctor if you cannot stop.
• Do not use antibiotics in the 4 weeks before, otherwise the test can miss the bacterium.

With a positive result and stomach complaints, the GP usually prescribes a 10-day course of two antibiotics and an acid-reducing medicine, followed by a follow-up test to see whether the bacterium is gone. With a negative result, the GP looks at other causes of the complaints.

With persistent or recurrent stomach complaints, the Dutch GP guideline (NHG) on stomach complaints prefers an antigen test in the stool, because it shows an infection at this moment. The result is only reliable if you stop the requested medicines in time. A positive result does not tell whether the complaints are actually caused by the bacterium.

• Acid-reducing medicines of the proton pump inhibitor type (for example omeprazole or pantoprazole) must be stopped 2 weeks before the test; other acid-reducing medicines such as famotidine 1 day beforehand.
• No antibiotics may have been used in the 4 weeks before the test; otherwise the result may be falsely negative.
• After treatment against the bacterium, it takes a few weeks before a follow-up test is reliable.
• The quality of rapid stool tests varies; in children they have not proven reliable enough.

An estimated 20 in 100 people in the Netherlands have the stomach bacterium, and about 30 to 35 in 100 of people with stomach complaints; the number is falling. In people who grew up in countries around the Mediterranean, Eastern Europe, the Middle East, Asia, Africa, or Central and South America, this can rise to 75 in 100. Stomach and duodenal ulcers are largely caused by this bacterium.

According to the Dutch GP guideline (NHG) on stomach complaints, useful with persistent or recurrent stomach complaints before you start an acid-reducing medicine, in people who lived as a child in an area where the bacterium is common, and as a check after treatment against the bacterium. In people without stomach complaints, a positive result says less: most people with the bacterium do not notice anything, and whether treatment is then worthwhile has not been established.

• A positive result without symptoms can lead to a course of antibiotics whose benefit in that situation has not been established, with a chance of side effects.
• A falsely negative result due to acid-reducing medicines or antibiotics can give false reassurance.

• NHG-Standaard Maagklachten
• Thuisarts.nl: Ik krijg onderzoek naar de maagbacterie bij maagklachten
• Thuisarts.nl: Ik heb een maagzweer
• FMS Richtlijnendatabase: Helicobacter pylori-infectie bij kinderen, module Testen op feces
• Huisarts & Migrant: Helicobacter pylori