The Helicobacter breath test (Helicobacter pylori breath test or H. pylori breath test) is a non-invasive method used to detect Helicobacter pylori infection. This bacterium is often associated with gastric and duodenal ulcers, as well as stomach cancer.
Helicobacter pylori (H. pylori) is a spiral-shaped gram-negative bacterium that colonizes the gastric mucosa. It is the main etiological factor of chronic gastritis and plays a central role in the development of peptic ulcer disease and gastric cancer.
infection with H. pylori (oral–oral or fecal–oral transmission)
childhood acquisition
high-prevalence regions
infected household members
urease production
epithelial damage (CagA, VacA)
chronic inflammation
mucosal barrier dysfunction
progression to atrophy and intestinal metaplasia in susceptible individuals
Often asymptomatic.
Possible manifestations include epigastric pain, dyspepsia, bloating, nausea, ulcer-related symptoms, and anemia.
Urea breath test (¹³C/¹⁴C) — preferred non-invasive method
Stool antigen test
Endoscopic biopsy with histology / urease test when indicated
Eradication therapy according to Maastricht VI guidelines
Treatment duration: 14 days
Post-treatment testing ≥ 4 weeks after completion
Peptic ulcer disease, atrophic gastritis, gastric cancer, MALT lymphoma.
Prevention relies on detection, eradication, and follow-up in high-risk patients.
Persistent dyspepsia, anemia, family history of gastric cancer, or confirmed infection.
The breath test consists of several sequential steps.
First, the patient swallows a special capsule containing urea labeled with the C14 isotope.
Then, after approximately 15 minutes, the patient exhales into a dedicated indicator device.
If Helicobacter pylori is present, the bacterium breaks down urea and produces carbon dioxide, which is detected in the exhaled air.
Finally, the indicator is inserted into an analyzer, and the test result becomes available within a few minutes.
As a result, the test provides rapid and accurate detection of infection.
The Helicobacter pylori breath test offers several important advantages:
it is fast and highly reliable, with a sensitivity greater than 95%;
it is suitable for both adults and children;
it does not involve any invasive procedures;
results help determine the presence of H. pylori infection and guide appropriate treatment.
For these reasons, the breath test is considered one of the preferred non-invasive diagnostic methods.
To ensure accurate results, certain preparation rules should be followed.
Some medications must be temporarily discontinued before testing:
antibiotics should be stopped at least 4 weeks before the test;
proton pump inhibitors (such as omeprazole, pantoprazole, esomeprazole) and bismuth preparations should be stopped 2 weeks before testing;
antacids that reduce gastric acidity should be discontinued several days in advance, after consulting a physician.
Before the test, patients should not eat or drink.
In addition, alcohol consumption and smoking should be avoided on the day of testing, as they may affect the results.
It is important to inform the physician about all medications being taken and any existing medical conditions. This information helps ensure correct interpretation of the test results.
In many individuals, Helicobacter pylori infection may remain asymptomatic. However, in some cases it can lead to serious conditions, including gastric or duodenal ulcers, chronic atrophic gastritis, intestinal metaplasia, and other complications.
Therefore, timely detection plays a key role in preventing long-term gastrointestinal damage.
Testing for Helicobacter pylori is recommended if any of the following symptoms are present:
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