Which analysis for Helicobacter is more accurate. Everything you need to know about testing for Helicobacter pylori. What methods for detecting Helicobacter Pylori exist

A feature of Helicobacter is its unique ability to adapt to the acidic environment of the stomach, while other types of bacteria die in it.

The presence of Helicobacter in the body is fraught with the occurrence of diseases such as gastric ulcer or duodenal ulcer, gastritis and cancer.

In order to timely detect traces of bacteria and successfully get rid of it, a stool test for Helicobacter pylori is performed.

The name of the analysis sounds incomprehensible, so many are interested in the question of what it is.

What is Helicobacter pylori

Weakened immunity becomes a prerequisite for further penetration of Helicobacter pylori infection into the duodenum, which provokes inflammatory processes and serious pathologies of the gastrointestinal tract.

Distribution routes

A very dangerous bacterium for humans penetrates the digestive system in the simplest way:

• through dishes;
• in case of non-compliance with the rules of personal hygiene;
• through saliva, kiss.

Carriers of the bacterium do not always experience discomfort and malaise, many of them do not have symptoms characteristic of helicobacteriosis. This is due to the ability of the bacterium to stay dormant for a long time and not manifest itself in any way.

The trigger that provokes the harmful effects of infection can be the lack of proper nutrition, stress and ignoring basic hygiene skills.

To prevent the destructive activity of Helicobacter pylori, a number of diagnostic measures should be taken to identify it.

When should an analysis be done?

The indications for the analysis are the patient's complaints about the manifested functional disorders in the digestive tract. The following symptoms are warning signs:

• pain during a long break between meals, subsiding immediately after eating;
• frequent bouts of heartburn;
• rejection of protein (especially meat) dishes up to vomiting;
• stomach discomfort, feeling of heaviness;
• discomfort from stagnation of the food bolus in the stomach;
• mucus in feces;
• lack of appetite.

Similar symptoms indicate a clear trouble in the digestive system. It can be caused by the activation of bacteria, the timely detection and elimination of which will help prevent serious complications.

Diagnostic methods

Determining the presence of a pathogen in the stomach is possible using such effective diagnostic methods as:

Blood from a vein is used as a biomaterial for a hemotest.

Despite the fact that the results of stool PCR and ELISA are considered the most accurate laboratory data, in some cases additional diagnostic procedures are resorted to.

As an auxiliary survey, the following measures can be used:

To obtain the most accurate information about the presence / absence of Helicobacter pylori, two or three research methods are used.

Reliability of stool test results

Unfortunately, none of the above methods can indicate with a 100% guarantee the presence of this type of infection in the body.

The study of feces using polymerase chain reaction (PCR) is no exception. This is explained not by the insufficient effectiveness of the method itself, but by factors that can lead to inaccurate diagnosis.

Among them, the following situations should be noted:

1. The analyzed fecal fragment may contain various components that affect the result of determining the presence of bacteria. This is the presence in the sample of blood, inorganic salts and other substances.
2. A positive, as well as a negative, result can be triggered by taking antibiotics (Metronidazole, Tetracycline) and other medications.
3. Most often, inaccuracy is observed due to improper preparation of the patient for analysis or errors in the collection of material.

How to get tested correctly

The reliability of the result directly depends on three factors:

• compliance with the recommendations for preparing for the analysis;
• accuracy of compliance with the rules for collecting biomaterial;
• timely delivery of samples for research.

A significant role in ensuring the accuracy of the results is given to the qualitative examination of feces in the laboratory.

Preparation rules

Fulfillment of simple but important requirements will make it possible to recognize the presence of Helicobacter pylori in the body in time. In the process of preparation it is necessary:

• exclude antibiotics 30 days before the examination;
• 3-5 days before collecting the material, do not eat foods that can change the color of feces (blackcurrant, red beet and wine);
• refuse during the same period from eating dishes prepared from meat, fish, cabbage, beets, radishes, carrots;
• you should also exclude the use of drugs that cause an acceleration of the defecation process, as they provoke a change in fecal masses and affect the results.

You should refrain from collecting biomaterial during the menstrual cycle. It is not recommended to do this after an enema, colon examination, or x-ray of the digestive tract.

How to collect biomaterial

To collect the material, you must use a special container. It can be purchased at a laboratory or pharmacy. You should not fill the container completely, it will be enough to place no more than ½ teaspoon of feces in it. This will be about a third of the container.

The use of non-sterile containers may lead to inaccuracies in the study. Do not donate feces that contain traces of urine or blood.

It is important to know how to properly pass the analysis to the laboratory. The faster the biomaterial is sent there, the more accurate the analysis will be. Exceeding the storage time (the norm is no more than 8 hours) and temperature conditions (in the range from + 3 to -7 ° C) is unacceptable.

How to decipher and evaluate the result of the analysis

Sowing biomaterial for the presence of Helicobacter pylori bacteria in the body by PCR shows two options: positive (infection is detected) and negative (it is absent).

A positive analysis does not always indicate that the Helicobacter pylori found in the feces is active. It can also indicate its presence at rest. Differentiation is possible only upon receipt of the results of a blood test for Helicobacter pylori by ELISA.

Each method has its own advantages. So, PCR detects the smallest number of bacteria, and ELISA determines at what stage of development the pathological process is.

Having received the data of the analyzes, one should not engage in fortune-telling about what this would mean. You need to immediately hand over the results to a gastroenterologist. Their decoding is the prerogative of competent specialists who will do it professionally, assess the degree of danger to the patient and prescribe an adequate course of therapy.

About treatment

In order to destroy the bacteria, the most effective use of antibiotics - Amoxicillin and Clarithromycin.

They are used if the patient has pathologies such as ulcers, gastritis and other disorders in the gastrointestinal tract.

Ignoring these diseases can lead to a high risk of developing irreversible consequences due to the possibility of oncological processes.

Prevention

To prevent infection, you must follow the basic recommendations:

• observe the rules of personal hygiene;
• wash hands before eating;
• use only your own dishes;
• do not use personal items (toothbrush) of another person;
• try to avoid greetings in the form of kisses.
• once a year to carry out preventive tests.

It is advisable to familiarize children with these rules, they have long been familiar to adults.

Statistics show that more than 50% of the population is affected by Helicobacter pylori infection. It is a provocateur of duodenal ulcers in 100% of cases, gastric adenocircomas in 80% of patients.

The provocateur of dangerous diseases is easy to defeat if it is detected in time.

A timely analysis can help eliminate the disease even at an early stage of its development. But on the condition that the most effective research methods are chosen.

Ways of infection and methods for detecting Helicobacter pylori

You can immediately tell which analysis for Helicobacter is the most accurate, this is a histological test. But, to take to confirm or deny the presence of the Helicobacter pylori bacteria in the body, at least two analyzes should be taken. After all, there is always a risk of error, and a lot depends on which second type of analysis will be chosen by the doctor.

To detect Helicobacter pylori, the following tests are used:

• Bacteriological;
• Histological;
• Urease respiratory;
• Immunological;
• Serological.

It is worth knowing that each method has its own advantages and disadvantages. Therefore, in order to determine the exact result, it is recommended to take 2 - 3 different types of analysis. The answers received will make it possible to more accurately determine the presence or absence of Helicobacter pylori.

Helicobacteriosis is an intestinal infection. Therefore, almost anyone can develop this disease. Helicobacter pylori can enter the human body in 3 ways:

• Fecal-oral. Bacteria present in the feces of a sick person enter a healthy body through the oral cavity. Penetration can be carried out through food, water;
• Oral-oral. Infection occurs by kissing through saliva. Children from sick parents can become infected with the disease through spoons and forks;
• Iatrogenic. Very rarely, but there are cases of infection with Helicobacter pylori through medical instruments used in the examination of the gastrointestinal tract.

And although in most cases the infection of this type of intestinal infection occurs from a person. This infection can also penetrate through pets, dogs, pigs or cats. Helicobacter pylori can be present for a long time secretly in the body. And only when favorable conditions for reproduction appear in the form of stress or a decrease in immunity, the infection actively begins its reproduction, provoked by the development of pathologies in the gastrointestinal tract.

Features of methods for detecting intestinal infection

Before prescribing to test the body for the presence of a virus, the doctor always considers several options at once. The fact is that each analysis used in the detection of infection is not able to give a 100% answer. Therefore, at least two types of completely different analyzes aimed at identifying one infection are always prescribed.

• Bacteriological. Its accuracy reaches 90%, and it also allows you to get more important information about the infection. This analysis makes it possible to accurately identify which antibiotics the strain has susceptibility to. Despite this high detection rate, this assay should only be used if there is little or no susceptibility to clarithromycin in the population. It also becomes relevant in a situation where previously used therapy has not shown the desired results;
• Histological. Refers to one of the most accurate analyzes. Its accuracy level sometimes reaches 100%. The mucosal tissue used for this procedure is carefully examined for the presence of special elements that indicate the development of infection. This analysis allows you to identify the most approximate number of bacteria and determine their level of sensitivity to certain antibiotics;
• Urease-respiratory. The air exhaled by a person is used as a test material for the presence of Helicobacter pylori. The fact is that Helicobacter pylori promotes the decomposition of urea into elements such as ammonia and carbon dioxide. This analysis is taken to identify these elements in the exhaled air. Despite the fact that this analysis is one of the easiest, unfortunately, its result is always in doubt, since it is only 80-85%. Therefore, it is used more often in only two cases, this is the primary diagnosis if this type of infection is suspected and the subsequent check of the effect of the drugs used in the treatment of the disease;
• PCR. This analysis is particularly sensitive, for this reason, it has a number of advantages over other research methods. It is able to detect not only acute, but also a pathogenic type of infection. He is able to detect them, even if their number does not exceed single copies. Detection by a microorganism in this way occurs literally after 5-6 hours;
• Immunological. This analysis is done more often at the beginning of the diagnosis and subsequently to clarify the effectiveness of the treatment method. The reliability of the result reaches 80%;
• Serological. This analysis is given during the initial diagnosis. But because of the lack of information. It is taken only by adults, since in children, due to their weak immune system, it is not able to detect the presence of a present or traces of a past infection.

It is worth knowing, only the doctor decides which analysis will need to be taken for an intestinal infection. The choice of analysis is influenced by many factors, including symptoms indicating the presence of the Helicobacter bacterium.

How long do retests take?

Each method used in the detection of Helicobacter pylori has its own series of features that are present not only in the conduct and delivery of the analysis, but also in the timing. After all, it will be necessary to take tests to identify intestinal infections after the course of treatment. And from what method of research will be assigned, it will be clear not only how to pass an analysis for Helicobacter pylori, but after what period after the course of treatment.

If a urea breath test is prescribed for a second examination by a doctor, then it is better to do it 4 to 6 weeks after the end of the course of treatment. An immunological study can show the result more precisely. But only in the case of the presence of an intestinal infection in the body. Unfortunately, the negative answers they often show turn out to be erroneous. Often the cause of a false answer is constipation. Research by this method is best done 2 weeks after treatment.

Gastroscopy is an effective method. It allows you to assess the condition of the mucosa and eliminate the likelihood of developing oncopathology. But due to the specifics of its implementation, many refuse to hold it. If you decide which method is better and easier, then, of course, urease-respiratory. But if you are interested in which of them is most accurate, the result will be given precisely by gastroscopy.

Analyzes for Helicobacter pylori: types, norm and interpretation

Helicobacter pylori is a pathogenic spiral bacterium that is resistant to the effects of gastric juice. Once in the body, it settles in the mucous membrane of the stomach and intestines, leading to its inflammation, the development of erosions, gastritis, and peptic ulcer.

Timely detection of Helicobacter pylori infection is the key to successful treatment of these and other pathologies, including cancer.

When is an analysis for H.pylori needed?

An analysis is needed when a person complains of discomfort and pain in the gastrointestinal tract. Symptoms that require testing for the presence of this bacterium are:

• regular heartburn;
• heaviness in the stomach;
• painful sensations, in particular those that disappear after eating;
• rejection by the body of meat food up to nausea and vomiting.

Laboratory examination is carried out if there is a suspicion of peptic ulcer, inflammatory pathologies of the gastrointestinal tract, gastritis, malignant tumors.

It includes four methods:

• ELISA - enzyme immunoassay for antibodies to Helicobacter pylori;
• UBT (urea breath tests) - urea breath test;
• PCR - study of feces;
• mucosal biopsy with cytology.

What do the tests show?

blood test for hylobacter pylori

Shows the presence and concentration of antibodies to Helicobacter pylori in the blood. Their appearance is a signal that the immune system has detected the pathogen and began to fight it.

For each type of pathogens, their own immunoglobulins are produced. Antibodies to H. pylori appear in the blood from a week to a month after infection and are of three types: IgA, IgG and IgM. They indicate the presence and stage of development of the infection.

This method is the most reliable, with its help, the pathogen's DNA is detected in the patient's feces.

PCR finds even a negligible amount of bacteria, which helps to predict the disease and reveals a tendency to develop gastritis, cancer of the stomach, intestines and other pathologies associated with Helicobacter pylori infection.

H.pylori bacteria secrete an enzyme, urease, to protect against gastric acid. It has the property of splitting urea into two substances - ammonia and carbon dioxide CO2, which is released during breathing and is detected by the urease test.

A breath test for Helicobacter pylori is performed using a urea solution labeled with carbon isotopes. For children and pregnant women, a less accurate but safe urea helic test is used.

This type of study shows the presence of Helicobacter pylori in gastric mucus. The test is considered positive when at least one bacterium is detected, and depending on the amount of H. pylori, the degree of contamination is revealed:

How to get tested for Helicobacter pylori?

To study for antibodies to H. pylori, blood taken from a vein is used. In a test tube, it is folded using a special gel that separates the plasma from the formed elements (platelets, erythrocytes, leukocytes).

In the presence of H.pylori bacteria in the body, it is in the plasma that the desired immunoglobulins are found. A blood test for Helicobacter pylori is taken in the morning, on an empty stomach. The day before, you can not eat fatty foods.

Fecal analysis requires preparation - within 3 days before its delivery, you can not eat food with a lot of fiber (vegetables, fruits, cereals), with dyes and salt.

During this period, it is also forbidden to give an enema, take antibiotics, drugs to enhance peristalsis, and use rectal suppositories.

A breath test for Helicobacter pylori is given as follows:

• The patient breathes twice into a tube placed deep in the mouth.
• He then drinks a test solution of urea labeled with carbon isotopes.
• After 15 minutes, he gives up 4 more portions of exhaled air.
• If the second test shows the presence of a carbon isotope in the samples, then the result is considered positive.

It is important that saliva does not get into the tube, otherwise the procedure will have to be repeated. 3 days before the urease test, it is forbidden to drink alcohol and foods that provoke gas formation in the intestines (legumes, cabbage, rye bread, apples, and others).

From 10 pm until the analysis itself, you can’t eat; on the day of the test, factors that increase salivation (chewing gum, smoking) should be avoided. One hour before the test, you should not drink anything.

In a cytological analysis, smears of gastric mucus taken during fibrogastroduodenoscopy (this is a method of examining the gastrointestinal tract with a probe) are studied.

Deciphering the results of the analysis for hylobacter pylori

Deciphering a blood test

In a blood test for Helicobacter pylori, the results depend on the presence or absence of immunoglobulins to the bacterium, as shown in the table below.

Three types of antibodies to H. pylori (A, G and M) appear at different stages of infection and help determine how much time has passed since infection.

• Early period of infection (when it is not yet detected).
• There are no H.pylori bacteria in the body.
• Recovery period, antibiotic therapy.

The urease breath test is either negative or positive.

Upon detection of Helicobacter pylori, a quantitative study is carried out using a mass spectrometer. At the same time, depending on the percentage of carbon isotope in the exhaled air, there are 4 degrees of infection (values ​​are indicated in percent):

Deciphering the analyzes of feces and gastric mucus is simple: they give either a negative result when bacteria are not detected, or a positive result.

Analysis rate

Laboratories conducting blood tests for Helicobacter pylori have their own reference values, or normal values. They are always indicated on the form.

A value below the threshold is considered a negative result, and a value above the threshold is considered a positive result. For example, for IgG antibodies, the following numbers are often used (in U/L):

1. above 1.1 - the development of infection;
2. below 0.9 - no infection;
3. from 0.9 to 1.1 - doubtful values ​​that require additional verification.

More often, infection with Helicobacter pylori carries a risk for the development of peptic ulcer and gastritis, therefore, for an accurate diagnosis of the pathology, along with laboratory tests, the gastroenterologist prescribes other research methods.

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Tests for Helicobacter: types, reliability, preparation and results

The main cause of the development of chronic gastritis and stomach ulcers is the bacterium Helicobacter pylori (Helicobacter pylori), therefore, if there are symptoms of these diseases, an analysis is made for this infection. What is it, in what cases should it be taken, how to decipher the results and how to treat the infection?

Tests for Helicobacter

There are several ways to diagnose HP infection (HP is short for Helicobacter pylori), they have different reliability and differ in time and cost. Which of the methods is faster and cheaper, and which one will show the result more accurately?

Methods for laboratory diagnosis of Helicobacter pylori infection are divided into invasive and non-invasive. Invasive ones involve endoscopy with the taking of biomaterial (biopsy) and subsequent cytological examination.

Polymerase chain reaction (PCR) is a molecular genetic study that allows you to identify DNA fragments of the causative agent of helicobacteriosis. Fecal masses are used as the studied biomaterial. During the analysis, a section of bacterial DNA is isolated from the biomaterial, which is then repeatedly duplicated on a special device - an amplifier. When the amount of DNA is sufficient for further detection, it is determined whether a genomic fragment characteristic of Helicobacter pylori is found in the sample. A positive result indicates the presence of Helicobacter pylori infection. PCR analysis allows you to confirm the presence of a foreign microorganism in the body with an accuracy of 90-95%. Normally, the genetic material of Helicobacter pylori is not detected in the test material.

Immunological methods do not directly determine the pathogen, but detect antibodies to its characteristic antigens.

The main method of blood analysis for antibodies is enzyme immunoassay (ELISA) - quantitative determination of the level of antibodies of the IgA, IgM and IgG classes to Helicobacter pylori. ELISA also allows you to evaluate the effectiveness of infection therapy. Thus, the production of IgM antibodies to Helicobacter pylori is a marker of the acute stage of the process. A few weeks after the initial infection, IgM disappear. With the progression of the disease and its transition to a chronic form, antibodies of the IgA class are detected, then IgG. High levels of their concentration remain in the blood for a long time. The sensitivity of the method is 87-98%.

Immunoblotting

Immunoblotting is significantly inferior to other immunological methods both in terms of cost and laboriousness of the analysis, however, only with its help it is possible, having only the patient's blood serum, to obtain data on the properties of the Helicobacter pylori strain (based on whether it produces specific CagA and VacA antigens). ).

Breath tests

Breath test - determination of the products of hydrolysis of urea by H. pylori urease in the air exhaled by the patient. The study is based on the ability of the bacterium to produce the hydrolytic enzyme urease. In the digestive tract, urease breaks down urea into carbon dioxide and ammonia. Carbon dioxide is transported to the lungs and released with air during breathing, its amount is recorded by a special device for urease analysis. Breath tests for Helicobacter are divided into carbon and ammonia.

Microbiological methods

Microbiological and bacteriological methods are used less often, since they take more time to carry out. They involve bacteriological culture of feces, isolation of the culture of the pathogen and determination of its sensitivity to antibiotics. During the study, the feces are placed in a growth medium that is favorable for growing colonies of Helicobacter pylori. After a certain period of time, the culture is studied under a microscope, noting the number of colonies and their properties.

The main signs that may indicate infection with Helicobacter pylori are typical symptoms of diseases of the gastrointestinal tract.

The decision on the choice of method is made by the attending physician. If an HP infection is detected in a patient, it may be appropriate to examine the patient's family members.

Preparation for analysis

To pass the analysis for Helicobacter, special preparation is not required, but it is important to follow the general rules, since only correctly collected material guarantees the reliability of the result. As a rule, all tests are taken on an empty stomach, that is, after at least eight hours of abstinence from food. Before the study, you should exclude alcohol, smoking, eating fatty and fried foods. When collecting material yourself, for example, for fecal analysis, it is important to avoid contamination of it, since any foreign particles (for example, detergents used to clean the toilet or bedpan) can distort the result.

An important rule when taking tests: within a month before taking the material, the patient should not take antibiotics and drugs that stimulate gastric motility.

How the results are decoded

If a qualitative analysis was carried out (determination of the presence of Helicobacter bacteria in the body), then in the result form there can be only two options - “negative” or “positive”. If the method of analysis involved a quantitative assessment, the norms of the results depend on the methodology, laboratory, units of measurement and other factors, so only a doctor can interpret the results of the analysis, he also makes the final diagnosis and prescribes treatment.

Helicobacter pylori and its features

Until the 70s of the last century, it was believed that any bacteria that enter the stomach die under the influence of hydrochloric acid, lysozyme and immunoglobulin. In 1989, researchers were able to isolate and cultivate a spiral-shaped microorganism from the gastric mucosa of a patient suffering from gastritis - the bacterium Helicobacter pylori.

The most informative of non-invasive tests are immunological studies, which determine the presence of antibodies to Helicobacter pylori in the blood, the H. pylori antigen in feces, PCR tests to identify the genetic material of the bacterium, and breath tests.

The name of the microorganism comes from "pylori", indicating its place of residence (the pyloric part of the stomach), and the characteristics of the form - "helico", which means "spiral".

Infection with a bacterium usually occurs through contact with dirty surfaces, through saliva, by airborne droplets, as a result of contact with an infected patient, non-compliance with personal hygiene rules, eating insufficiently clean vegetables and fruits, and water from contaminated sources.

If a qualitative analysis was carried out (determination of the presence of Helicobacter bacteria in the body), then in the result form there can be only two options - “negative” or “positive”.

Infection caused by Helicobacter pylori is associated with chronic gastritis, peptic ulcer of the stomach and duodenum, malignant tumors of the stomach (adenocarcinoma, B-cell lymphoma).

Symptoms of Helicobacter pylori infection

The main signs that may indicate infection with Helicobacter pylori are typical symptoms of diseases of the gastrointestinal tract:

• pain in the epigastric region;
• bad breath;
• sour belching;
• heartburn, nausea, vomiting;
• loss of appetite;
• feeling of heaviness after eating;
• increased gas formation;
• prolonged constipation or loose stools, as well as their alternation.

Video from YouTube on the topic of the article:

Education: Rostov State Medical University, specialty "Medicine".

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What tests to take for Helicobacter pylori

Every disease has a cause. And the effectiveness of treatment and the future health of the patient depends on how correctly it is determined. Various diagnostic methods help in establishing the cause of gastritis and ulcers: instrumental and laboratory.

Consider the main ways to identify one of the most common bacteria that can cause gastrointestinal problems - H. pylori.

How to determine the presence of Helicobacter pylori in the stomach

It is not possible to see such a tiny organism with a length of only 2-3 microns with an eye, as well as to carry out diagnostics at home.

The patient can only assume the presence of gastritis by the corresponding symptoms: epigastric pain after eating, heaviness and discomfort in the stomach, heartburn, belching with air or sour, metallic taste in the mouth. These signs of acidity very often accompany gastritis associated with a pathogenic microbe.

But it is possible to reliably determine whether the Helicobacter pylori bacterium has settled in the body or not, only in the diagnostic department of an outpatient clinic, hospital or laboratory.

There are special methods that allow with high reliability to detect both the microbe itself and its metabolic products, as well as the antibodies produced by the body in response to the introduction of the microbe:

Detection of a pathogen in smears from a section of the inner wall of the stomach or cultivation of a microorganism on nutrient media.

Detection of antibodies in the blood, antigens of microbes in the feces.

Identification of H. pylori under a microscope by coating the research sample with special dyes.

• Molecular genetic

Polymerase chain reaction methods.

Urease test, breath test.

All of the above methods can be classified into two large groups:

1. Invasive. Diagnostic methods based on endoscopic examination - FGDS, with a biopsy. A section of the inner wall of the stomach can then be subjected to a cytological, cultural study, and a urease test can be performed.
2. Non-invasive. Other methods of detecting infection in which EGD is not performed.

Analysis for Helicobacter pylori (helicobacter pylori) - what is it

The doctor, before conducting research and diagnosis, whether there is a pathogenic microorganism in the stomach or not, it is necessary to take biological material from the patient. Such material can be:

• A small area of ​​the gastric mucosa.

A piece of mucous membrane is split off during fibrogastroscopy - a biopsy is performed with a special device right during FGDS.

A blood test does not detect the bacterium itself, but the immunoglobulins that are formed in the body in response to an infection: IgA, IgG, IgM. Read also the transcript of tests for Helicobacter pylori infection.

When N.rulori enters the stomach and actively reproduces, the immune system launches a cascade of reactions aimed at expelling the harmful microorganism. This is manifested in the production of specific antibodies that bind the microbe and seek to neutralize its toxins.

Antibodies or immunoglobulins (IgA, IgG, IgM) in excess of the norm may appear several weeks after infection, and their high level persists for some time after successful eradication - therapy for helicobacteriosis.

Fecal analysis allows you to identify bacterial DNA fragments in feces using a special high-precision polymerase chain reaction (PCR) method.

This method is very convenient for the following categories of people: elderly, debilitated patients, people who have contraindications for EGD with biopsy, young children. It is non-invasive and painless.

The disadvantage of the method is that even after therapy and getting rid of the infection, the remnants of the bacterial DNA of the dead H. pylori continue to come out with the feces, and the analysis may remain positive.

To conduct a breath test, the patient is offered to ingest a special solution containing labeled 13C isotopes of urea. This aqueous solution is safe for the body.

After the patient has drunk it, 4 samples of exhaled air are taken within an hour at 15-minute intervals. The method is based on the ability of the pathogen to break down urea and convert it into ammonia and carbon dioxide.

The content of the 13C isotope in the exhaled air is determined with a special device, a mass spectrometer. Normally, it does not exceed 1% of the total amount of carbon dioxide. If the indicator is exceeded, there is an infection with a bacterium.

This method is not available in all polyclinic institutions and its cost is high today. Its advantages are speed, painlessness and informativeness.

Analysis for Helicobacter in vitro

In vitro means "in glass" in Greek. This is a complex of diagnostic methods that are carried out outside the human body.

Helicobacter pylori infection is essentially diagnosed by all in vitro methods:

After taking the biopsy material, the mucosal area is imprinted on the glass, stained and examined under a microscope - the cytological method, or the biopsy is placed in a special medium - the urease test.

From a mucosal biopsy, cell cultures can be grown in a test tube or petri dish on special nutrient media - the microbiological method.

The study of urine and feces in order to detect antibodies and antigens of bacteria are also carried out in vitro, outside the human body.

What tests should be taken for Helicobacter pylori

Currently, there are a great many ways to detect a bacterium, its metabolic products and antibodies to it. Each of the methods has certain advantages and disadvantages.

Therefore, the patient is recommended to take several tests to confirm the presence of a microbe in the body, the doctor should recommend them, taking into account the specific clinical case and the technical equipment of the institution in which the diagnosis will be carried out.

Each patient must undergo EGD with a biopsy. Further, the study of the biopted mucosa is possible under a microscope, rapid tests, or by cultivating bacteria on nutrient media.

It will not be superfluous to donate blood and feces for serological diagnosis. Indeed, a high titer of antibodies of the bacterium or its DNE fragments in the feces can become a confirmation of infection.

A breath test is an excellent non-invasive method that allows you to reliably confirm the presence of a bacterium in the body and its activity. And if there is an opportunity to go through it in a medical institution, you should definitely use it.

Tests for Helicobacter pylori infection are taken not only to identify the microorganism, but also to control the cure. What kind of research is needed is always determined by the doctor.

What analysis for Helicobacter pylori is the most informative

The correct analyzes are:

• cytological method, when the doctor observes the presence of bacteria under a microscope
• culture method - growing bacteria on nutrient media
• PCR diagnostic method or molecular genetic method - detection of genes or DNA fragments of a bacterium

All these methods are based on the initial biopsy - a piece of gastric mucosa during EGD. They are invasive. Without “swallowing the tube”, these methods cannot be carried out.

Unlike the methods of serological blood testing, in which antibodies are detected that indirectly indicate the presence of a microbe in the body or enzyme methods that can diagnose its metabolic products, cytology reveals the pathogen in its entirety, in person.

For this study, smears-imprints of biopsy specimens of the gastric mucosa are used. It is important to take a biopsy from the most informative areas and suspected habitats of the bacterium - more often this is the antrum.

The smears are dried, stained with special dyes and examined under a microscope. Bacteria are located in the mucus, they are S-shaped or spiral-shaped, have flagella at the end of the body. An experienced eye of a diagnostician will not confuse these microorganisms with any others.

The cultural method allows you to grow a whole colony of bacteria on special nutrient media. Pathogens love an environment with a low oxygen content (no more than 5%), blood nutrient media are used for their cultivation.

Under favorable conditions, compliance with the temperature regime during cultivation and anaerobic conditions, after 3-5 days, round, transparent colonies of bacteria grow on the medium, which are then subjected to identification.

PCR methods for detecting genes and fragments of Helicobacter pylori DNA are informative, but require special equipment and reagents. Not every polyclinic institution has it today.

What analysis is best to pass on Helicobacter

The list of tests should be determined by the doctor, taking into account the specific case and the purpose of the study.

For prophylactic purposes, without complaints from the gastrointestinal tract, you can use non-invasive diagnostic methods (without FGDS):

• blood test for serological detection of antibodies to the microbe
• stool analysis for PCR diagnostics of DNA fragments
• breath test

If there are complaints from the gastrointestinal tract or suspicion of infection, it is necessary to conduct an EGD, followed by taking a section of the gastric mucosa. In this case, a cytological, cultural, urease rapid test or PCR diagnostics of the biopsy is recommended.

There is no "gold standard" for diagnosing a microbe. All methods complement each other, so you need to use several of them. The choice and tactics of diagnosis is the prerogative of the attending physician.

How is Helicobacter pylori tested?

If they want to diagnose the bacterium itself or its fragments, they take a section of the mucous membrane from the stomach with a special device during FGDS. The doctor determines the puncture site - these are the most hyperemic and swollen areas of the inner gastric wall. You can not take a piece from the bottom of erosions or ulcers for research.

If the purpose of the diagnosis is a preventive examination or evaluation of the effectiveness of treatment, non-invasive methods can be used: take a blood test, feces, and conduct a breath test.

Before conducting invasive tests, the patient is required to prepare only for an endoscopic examination - fibrogastroscopy.

Blood for research is taken from a vein; analysis does not require special preparation from the patient. It is advisable to donate blood on an empty stomach, in the evening we will allow a light dinner, it is not advisable to overeat or eat fatty foods.

Before analyzing feces, you should eat properly for 3 days: do not eat foods containing a large amount of dyes and preservatives, coarse fiber foods, do not take medications, alcohol.

Preparation is also important before the breath test. You can not eat after 22.00 in the evening on the eve of the test and in the morning. Two days before the study, exclude all products that increase gas formation and liquids that can increase the concentration of CO2 with exhaled air: cabbage, legumes, apples, muffins, soda. You can not drink alcohol and smoke, use chewing gum.

Their quality and result depend on how consciously the patient reacts to preparing for the tests. And that means subsequent treatment and general well-being.

Test for Helicobacter with FGDS and gastroscopy

Rapid tests in the diagnosis of bacteria are gaining wide popularity. They are quite informative, allow you to quickly establish the infection of H. pylori within a few minutes after the FGDS. These are rapid urease tests.

They are based on the ability of the microbial enzyme urease to break down urea with the release of ammonium. Ammonium ions create an alkaline environment and contribute to the color change of the express system indicator.

The one-time express kit includes:

• urea
• pH indicator (initially yellow)
• bacteriostatic agent

During FGDS, a section of the mucosa is taken. This section is placed on the speed dial panel. If this mucosa contains a microbe, its urease enzyme begins to actively break down the urea contained in the test.

Ammonia is released, alkalizes the medium, the indicator reacts to its release and changes its color from yellow to crimson. The test is estimated from several minutes to a day. Raspberry staining will indicate the presence of infection and a positive test.

If the color change of the indicator did not occur, or it appeared after a day, the result is considered negative. There is no pathogen in the biopsy.

FGDS with a biopsy for Helicobacter pylori

Required for persons who:

1. Have symptoms of pathology of the gastrointestinal tract: heartburn, nausea, discomfort or pain in the epigastrium, a metallic taste in the mouth
2. Have close contact with people who have already been diagnosed with this infection, or among family members this diagnosis is established
3. They already have a history of gastritis, esophagitis, an ulcer without an established etiology
4. Completed a course of eradication therapy for this infection to assess the quality of treatment
5. Have skin problems of unknown etiology, immune disorders
6. Successfully treated for H. pylori with reliably confirmed laboratory data, for the prevention of reinfection 1 time per year.

Article content:

With complaints of pain and discomfort in the stomach area, an analysis for Helicobacter pylori is indicated. Its interpretation is important for determining the tendency to a stomach ulcer, as well as the presence of a pathogenic agent in the body. It is important to understand correctly that the analysis for Helicobacter pylori indicates the norm with a negative result. In other words, this bacterium is not found in the human body.

General idea of ​​bacteria

Helicobacter pylori is one of the most dangerous bacteria in the human body today. The bacterium most often lives in the pylorus, that is, in the lower part of the stomach, which gradually passes into the duodenum. Helicobacter is an anaerobic bacterium, that is, it can exist without oxygen. It is transmitted from one person to another through saliva and mucous compartments, subject to the general use of utensils, hygiene items. Cases of infection even through a kiss are known.

This microbe is very resistant to gastric juice and does not die in the presence of hydrochloric acid, which is harmful to other bacteria. Therefore, the pathogen can penetrate the mucous membrane and disrupt its structure. Helicobacter activity in the gastric mucosa potentially leads to inflammation (gastritis) as well as peptic ulcers.

Who needs to analyze

It is necessary to take an analysis for the Helicobacter bacterium with such symptoms:

• stomach pain after eating;
• heaviness in the stomach;
• the appearance or intensification of heartburn;
• a feeling of intolerance to food from meat;
• chronic pathologies of the stomach, duodenum.

In addition, an analysis for Helicobacter pylori is necessary for those who have a history of diseases such as ulcers, dyspepsia, atrophic gastritis. It is also necessary to identify Helicobacter pylori if a blood relative has stomach cancer, and also if this pathogen is present in the body of cohabiting family members.

Features of the respiratory analysis

In modern conditions, doctors often attribute their patients to a breath test for the presence of the bacterium Helicobacter pylori. The diagnostic system is a disposable indicator tube and a compressor. She diagnoses the composition of the air that a person exhales.

Such diagnostics allows for primary diagnostics for the presence of microorganisms in the human body, as well as control of antibacterial treatment against Helicobacter pylori. The analysis system is often used for diagnosis by family doctors, pediatricians, and gastroenterologists. It has a high accuracy rate - over 95%.

The principle of operation of this analysis is based on the fact that the bacterium Helicobacter pylori has urease activity, that is, it is able to hydrolyze urea (urea). The patient must take a normal isotopic solution of this substance. During hydrolysis, gas is formed, and it enters the oral cavity. The diagnostic tube contains a special chemical composition that changes color in the presence of gas. That is, the norm of such an analysis is the invariance of the color of the indicator tube intended for analysis.

How is blood tested for the presence of Helicobacter

A blood test for Helicobacter pylori allows you to detect the presence of Helicobacter pylori infection in the body. The analysis shows the presence in the blood of various immunoglobulins - the reaction of the immune system to an extraneous microbe. The norm of such an analysis is a reference (threshold value). If the indicators of the presence of immunoglobulins are below this threshold, then the result is negative, and if it is higher, then it is positive.

Before taking the test, the patient does not eat for eight hours, as well as drinks - tea, coffee. You must also refrain from smoking.

A blood test for Helicobacter is combined with the study of proteins produced by blood cells in response to the presence of pathogens of infectious diseases. Immunoglobulins are divided into types, denoted by the letters of the Latin alphabet - A, M, G. Immunoglobulins in the results of the study are designated respectively as IgA, IgM, IgG. The norm is also indicated on the form, next to the actual indicators, for comparison.

How is the result decoded?

Immunoglobulin IgG confirms the presence of Helicobacter in the body. These cells appear from the third or fourth week after the infection enters the body. Such immunoglobulins persist for some time after the destruction of the infectious focus. In this case, they speak of a false positive result of the analysis. In addition, the presence of such an immunoglobulin indicates that a person is at a high risk of developing stomach cancer. If the result is negative, it is considered that there is no infection.

If the decoding of the analysis shows the presence of IgM immunoglobulin in the body, then this indicates an early infection. In addition, such an immunoglobulin indicates that inflammation of the gastric mucosa occurs. The absence of such an indicator indicates that there is no infection in the body.

If the decoding of such an analysis shows the presence of IgA in the blood, then this indicates a severe inflammation of the mucosa. However, a blood test for Helicobacter rarely shows an increased amount of such immunoglobulin. The absence of such an analysis indicates a period of recovery, as well as the fact that antibiotic therapy is being carried out effectively.

Determination of the presence of bacteria in the stool

Taking a stool test for the presence of Helicobacter pylori is also highly informative for determining infection.

Rules for passing the analysis:

1. Fecal sampling for analysis should be carried out only thirty days after taking any antibiotic.
2. Three days before taking the biomaterial, all foods with coloring matter, coarse fiber are excluded from the diet.
3. You do not need to use drugs that accelerate intestinal peristalsis.
4. Feces should be placed in a sterile container and delivered to a medical facility as soon as possible.

Remember that stool analysis can show negative results if it contains bile and bile acids, inorganic salts, and more. Therefore, in some cases, the doctor recommends a different diagnostic method.

In order for the result of the fecal analysis to be as accurate as possible, it is necessary to prepare for it. Women should not undergo this study if they have begun menstruation. The key to successful delivery is the cleanliness of the body and especially the genitals. Feces need to be taken only that which was not stimulated by the introduction of laxatives. Defecation for accurate analysis of feces should be only spontaneous.

It is also impossible to donate feces if droplets of urine have fallen on it. To place the feces in the container, you need to use a special spatula, which can be taken at the hospital. There should not be much material in the container. And one more important point: the feces must be taken to the hospital on the day when it was collected.

Gastroscopy to determine Helicobacter pylori

To determine Helicobacter pylori, it is imperative to carry out a standard gastroscopy for a urease test. Effective treatment of stomach diseases without such an analysis is impossible. This study is also called the HP test.

To conduct a urease analysis, a fragment of the mucous membrane is taken from the antrum of the stomach and from its body. These fragments are then placed in a container with a special reagent. By the way the color of the fragments of the mucous membrane has changed, they judge the presence and absence of infection. If the color of the mucous membrane fragment has not changed, then there is no Helicobacter pylori in the stomach.

Fragments of the gastric mucosa are taken for analysis with special biopsy forceps. They must be sterile, as this alone guarantees the accuracy of the results of the study. Gastroscopy occurs in a state of medical sleep, since the gag reflex distorts its results.

Properly performed tests for Helicobacter pylori make it possible to determine with a high degree of accuracy the presence of a dangerous microorganism in the human body and compare it with what is in the “norm” column. According to the results, treatment is prescribed.

It is important to detect the infection in order to begin targeted treatment that will remove pathogens from the person's body. You can learn more about the bacterium, its pathogenic properties from the article -.

Why you should get tested for bacteria regularly

Diagnostic methods

To identify pathogenic bacteria, scientists have developed many diagnostic tests. A wide range of studies allows you to choose a different type of examination for the patient with doubtful results of the first.

BLOOD ANALYSIS

The study involves the delivery of venous blood to determine the presence of bacteria and the titer of antibodies to Helicobacter pylori. The material is taken by a nurse with a vacutainer (tube with a needle). Answers usually come within 24-48 hours.

SCAL ANALYSIS

The procedure for taking feces is familiar to everyone since childhood. All you have to do is bring a sample, and the rest will be done by the laboratory assistants.

Such a diagnosis of Helicobacter pylori is more reliable and informative. With the help of antibodies in the feces of an infected person, antigens (protein structures located on the membrane of the pathogen) can be detected Helicobacter. The result is prepared within one day and can contain only 2 response options: negative (bacteria were not found in the feces) and positive (presence of infection).

Attention! Regular fecal analysis helps to track the dynamics of the development of the disease, prevent and start treatment of many diseases of the stomach (gastritis, ulcers, tumors) in time.

PCR feces for HELICOBACTER PILOR

The material for PCR can be not only biopsies of the stomach, duodenum, but also feces. This analysis makes it possible to identify bacterial strains, to study its pathogenicity factors and mutations that affect the development of antibiotic resistance.

Polymerase chain reaction for the detection of bacterial DNA is carried out in various ways: by hybridization, enzyme immunoassay, or immunoblotting. The use of real-time PCR determines not only the qualitative presence of the genetic material of microbes, but also quantitatively measures their DNA.

The analysis is prescribed as a diagnosis of chronic gastritis or peptic ulcer, if a malignant tumor in the stomach, duodenum is suspected.

Rules for donating feces for PCR:

• the material is collected in a special disposable container for feces (1/3 of its volume is filled);
• it is necessary to deliver feces to the laboratory within 6-12 hours after its collection;
• before the delivery of the material to a medical institution, it should be stored in a container at a temperature of + 2 + 8 degrees;
• Do not take antibiotics the day before the test.

In order not to get a false-negative result, it is advisable to carry out PCR of feces for H. Pylori one month after the cessation of antibiotic therapy, or 14 days after the end of taking bismuth preparations (De-Nol).

The analysis is considered negative if bacterial DNA was not detected.

UREASE (RESPIRATORY) ANALYSIS

The examination consists in the fact that the patient is given to drink a liquid that contains a solution of urea. After a short period of time, he is offered to make several exhalations into the tube connected to the analysis sampling bag.

The liquid that the patient drinks is marked with a special carbon isotope. Therefore, if there are bacteria on the wall of the stomach, they react with urea, releasing ammonia and carbon dioxide, to which the indicators of the device are directed. The test easily helps to detect Helicobacter pylori infection due to the increased content of CO2 and can be carried out at home. The cost of the analysis is 200-500 rubles.

UREASE TEST FOR FGDS

FGDS is the most accurate invasive method for diagnosing diseases of the stomach and duodenum. With it, you can detect not only inflammation of the mucosa, but also the presence of Helicobacter pylori.

The procedure is performed in the morning after preparation by the patient:

• the last meal should be taken 8-9 hours before the study;
• in the morning before the manipulation, you can not drink water;
• on the eve of the examination do not take drugs;
• Bring a disposable diaper and towel with you.

During gastroscopy, the most altered part of the mucosa is taken, which is immediately immersed in a special yellow solution. If bacteria are present in the tissue, they react chemically with the solution, giving it a different hue, from pale pink to bright red. This allows you to quickly determine the presence of infection.

Gastroscopy is considered the "gold standard" not only for the initial detection of gastritis, ulcers and helicobacteriosis, but also for monitoring after treatment. A second procedure is usually prescribed 2 weeks after the end of drug therapy.

The price of the procedure is from 2000 to 10000 rubles.

CYTOLOGICAL ANALYSIS

For cytological examination, smears-imprints of biopsy tissues obtained from the most affected areas of the duodenal or stomach membrane during FEGDS (visual assessment of the state of the upper gastrointestinal organs using an endoscope) serve as material.

In the laboratory, smears are placed on glass, dried well and stained with specific dyes (according to Pappenheim, Romanovsky-Giemsa).

The error is eliminated by almost 100%, since the technique allows you to reliably detect the presence of a microorganism, roughly assess its quantitative indicators.

Possible results of a cytological test:

• a negative response when no bacteria were detected;
• weak (+) - the number of microbial bodies does not exceed 20 in one field of view;
• medium (++) - smear shows 20-40 bacteria per field of view;
• high (+++) - over 40 microbial bodies.

Deciphering the analysis for Helicobacter pylori using cytology takes from 3 to 14 days and is carried out only by a laboratory doctor who can correctly count microbial bodies.

HISTOLOGICAL ANALYSIS

According to the method of execution, it is similar to cytological. During gastroscopy, a biopsy is also performed, the materials of which are sent to a special laboratory. The causative agent is detected by microscopy, DNA hybridization, or using monoclonal antibodies. In addition, the morphological state of the membrane is assessed, which allows you to check the severity and depth of damage to the stomach wall.

MOLECULAR BIOLOGICAL METHOD - PCR

The test is prescribed for the purpose of qualitative detection of the DNA of the microorganism - Helicobacter pylori. For this, biopsy specimens of the duodenum, stomach, and gums are also used. PCR makes it possible to detect a unique strain of bacteria in the adult human body, evaluate their phenotypic characteristics, and develop a special treatment strategy.

PCR is prescribed in the following cases:

• ulcerative lesions of the walls of the stomach, small intestine;
• pathological condition of the gastric mucosa with EGD;
• tumors, polyps, other neoplasms in the stomach area (malignant, benign);
• dysfunction of the esophagus, ulcers, erosion in its area, including reflux of stomach contents;
• genetic predisposition to oncological diseases of the stomach;
• to control treatment, track positive dynamics towards recovery.

EXPRESS TEST

These methods are of the least significance in the diagnosis of Helicobacter pylori, but are sold in almost every pharmacy and are easily performed at home. Testing may require blood or feces. The average price of tests is 500-1500 rubles.

You need to do the test in the morning on an empty stomach:

1. The reagent, indicator and pipette are laid out on a clean and dry surface, hands are thoroughly washed with soap and water and dried with a paper towel.
2. The finger is treated with an alcohol wipe and pierced with a scarifier in the pad area.
3. The tip of the finger is gently squeezed, the blood is collected in a pipette. Then 1 drop of blood is applied to the prepared indicator, 2 drops are added. special reagent.
4. The test is left on a horizontal surface for 15 minutes. The appearance of one strip means that the bacterium is not detected, and two - a positive answer.

If a fecal test was purchased, the material should be collected in a clean container, after no more than 100 g, placed in a test tube with a solvent. The sample is gently shaken until a homogeneous content is obtained. After 10 minutes, you can start the study: 2-3 drops of the composition are applied to a special test strip and a time of 10 minutes is waited. One strip indicates a negative answer, two - a positive one.

Normal Research Rates

In a healthy person with FEGDS, the mucosa is pale pink, without pronounced folding, erosion, ulcerative defects; a rapid urease test shows a negative result.

The absence of Helicobacter in smears indicates the norm (negative examination result). PCR detects DNA fragments of non-pathogenic microorganisms for humans. In the case of ELISA (to confirm the diagnosis), it is necessary to carry out a diagnostic titration of antibodies of the IgM class only.

Fecal analysis for Helicobacter pylori- this is reliable evidence of the presence in the human body of a bacterium that causes peptic ulcer and many other diseases of the human digestive tract. Such an analysis is direct evidence if either Helicobacter itself or its DNA is detected. The reliability of the analysis is the highest of all known.

The result depends on the correct preparation and collection of material. The presence of a person is not required, it is enough to deliver the correctly collected material on time.

Preparation for the delivery of the analysis

When preparing, you must strictly observe the following rules:

3 days is enough for preparation. At this time, it is advisable to give up all medications (if this is not possible, tell the doctor the names and dosage). It is necessary to reduce the consumption of fish and meat, cook them for a couple or boil. The best food at this time is cereals and sour-milk products, vegetable and fruit purees, weak soups, neutral natural juices (apple, white grape), compotes, fruit drinks, weak tea, rosehip broth.

Container preparation

Some laboratories issue containers for analysis, including their cost in the total price. This is the best variant. A container for feces can be purchased at a pharmacy, the cost is several rubles. The container is sold sterile and must not be opened, wiped or rinsed. A plastic spoon is attached to the lid, with which the material is collected.

In the most extreme case, you can use a glass jar with a well-fitting lid (from baby food). The jar needs to be washed well, and then boiled together with a lid and a spoon or other object that will collect feces. If bacteria remain on the dishes, the analysis will be incorrect.

Collection of material

It is impossible to collect material from the toilet bowl or diaper. The toilet should be covered with a clean plastic bag, and instead of a diaper (for a child or a bedridden patient), put an oilcloth on it. It is allowed to take material from a clean pot.

The container is filled no more than one third, tightly close the lid. Attach a referral to the dishes or write on the label (legibly) the patient's last name and first name, year of birth.

How and for how long can the material be stored?

The container with the material is delivered to the laboratory as early as possible, optimally on the day of sampling. If there is no possibility of urgent delivery, it is allowed to store in the refrigerator for no more than 2 days at a temperature not higher than +4 ° C. If longer storage is necessary, the material is frozen once at a temperature of -20 ° C.

Methods of analysis and interpretation of indicators

Biological material can be examined in various ways.

Other ways to detect Helicobacter

During the examination, several methods are usually used to finally verify the presence or absence of Helicobacter pylori:

The set of diagnostic tests depends on the equipment of the medical institution. Histological examination is considered the "gold standard". However, a positive result from at least two different tests is considered sufficient to confirm the presence of the bacterium.

What to do with a positive analysis?

Visit a gastroenterologist as soon as possible to find out if eradication (removal from the body) of the bacteria is necessary. This is an ambiguous process, there are contraindications, a doctor's consultation is necessary.

After assessing the level of health, the doctor chooses one of the schemes approved by the international community. Depending on the characteristics of the pathological process, drug combinations of drugs of the following groups are used:

During treatment, H. pylori tests may be repeated to monitor the effectiveness of treatment.

After the detection and removal of bacteria, ulcers and other mucosal lesions heal completely, and all secondary disorders stop - the microflora is restored, the synthesis of vitamins and hormones, digestion, and the risk of developing stomach cancer is reduced.