A blood test can say you have had H. pylori for years after it is gone. A breath or stool test, taken a month after treatment, is the one that answers the question people actually ask.
H. pylori is a stomach infection, and most people who have it never feel a thing.
When it does cause trouble, it damages the lining that protects the stomach from its own acid. An open sore forms. That sore is a peptic ulcer.
Below are the six signs worth knowing, then the treatment course, then the one test that proves the bacteria have actually gone.
Six signs of an ulcer, and one of them is silence
Mayo Clinic says H. pylori infections can cause stomach pain, bloating, gas and other symptoms. It also says most people who become infected do not get symptoms.
When symptoms do arrive, six patterns come up again and again.
- Burning pain in the upper belly. NIDDK says abdominal pain is the most common symptom of a peptic ulcer. It says the pain may be dull or burning, and that it comes and goes over time.
- Pain that arrives on an empty stomach. NIDDK says the pain may occur when the stomach is empty or at night, and may go away for a short time after eating. Mayo Clinic says the pain may feel worse when the stomach is empty.
- Pain that eating makes worse. NIDDK notes the other half of the pattern. For some people, eating makes the pain worse rather than better. Either direction counts as a pattern worth reporting.
- Filling up too soon. NIDDK lists feeling full too soon while eating a meal, and feeling uncomfortably full afterwards. Mayo Clinic lists loss of appetite alongside it.
- Bloating and frequent burping. Mayo Clinic names frequent burping and bloating among the symptoms. NIDDK lists bloating and belching as symptoms of indigestion from an ulcer.
- Nothing at all. NIDDK says many people who have peptic ulcers do not have any symptoms, and may not develop them until an ulcer leads to complications. Silence is not the same as safety.
There is a second list that does not wait. Mayo Clinic says to get help right away for bloody or black tarry stools, vomit that looks like coffee grounds, sudden severe pain, trouble swallowing, or unusual tiredness and dizziness.
Why the pill you take for your knee is on this list
NIDDK says the most common causes of peptic ulcers are H. pylori infection and nonsteroidal anti-inflammatory drugs. It names aspirin, ibuprofen and naproxen.
NSAIDs relieve pain. They also make the stomach lining more prone to damage.
NIDDK names the patterns that raise the risk. Taking NSAIDs for a long time. Taking a type more likely to cause an ulcer. Taking high doses, or more than one at once.
The last one matters most here. NIDDK says the risk is higher for people who take NSAIDs and are also infected with H. pylori. The two causes stack.
Contrary to popular belief, stress and spicy foods do not seem to increase the risk of ulcers.
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⬇ Download your plan (PDF)Why the follow up test is the only one that settles it
Harvard Health says a blood antibody test for H. pylori is widely available and simple to do. Then it names the catch.
The blood test results may remain positive for years after an infection has been treated. It also cannot tell whether an H. pylori infection caused an ulcer.
Two tests can be repeated after treatment. Harvard Health says the stool antigen test is more specific than the blood test. It says a urea breath test detects the bacteria directly.
The timing is the part worth writing down. Harvard Health says that a month or two after treatment finishes, a breath or stool test can confirm the bacteria are gone. If it is still positive, another course may be recommended.
Healing runs on its own clock. Harvard Health says duodenal ulcers take about six weeks to heal, and gastric ulcers up to two or three months.
Three ulcer beliefs that outlived the evidence
Three ideas about ulcers are still repeated daily, and all three have an answer.
Stress causes ulcers. Harvard Health says plainly that, contrary to popular belief, stress and spicy foods do not seem to increase the risk of ulcers. It names the real risk factors instead: family history, smoking, and excessive alcohol use. NIDDK puts H. pylori and NSAIDs at the top of the cause list.
A positive blood test means it is back. Not necessarily. Harvard Health says the blood antibody test may remain positive for years after an H. pylori infection has been treated. That is exactly why it says to confirm elimination with a breath or stool test instead.
No pain means no ulcer. NIDDK says many people who have peptic ulcers do not have any symptoms. It adds that some do not develop symptoms until an ulcer leads to a complication. Mayo Clinic says most H. pylori infections cause no symptoms at all.
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This article is education, not medical advice. Mayo Clinic says to get medical help right away for sudden severe stomach pain, black or tarry stools, vomit that looks like coffee grounds, trouble swallowing, or unusual tiredness, dizziness or passing out.