3161. PCR. Helicobacter pylori (stool, qualitative determination)

This test is elaborated for the non-invasive detection of Helicobacter pylori, an S-shaped gram-negative bacterium that colonizes the gastric mucosa and significantly increases the risk of developing gastric adenocarcinoma and B-cell lymphoma. Modern diagnostics of these diseases is impossible without accurate and rapid identification of H. pylori.

H. pylori can be detected using real-time polymerase chain reaction (RT-PCR), which is aimed at the highly accurate detection of bacterial DNA fragments in a stool sample. This is particularly useful for initial diagnosis and monitoring treatment effectiveness. Real-time PCR has high sensitivity (93-95%), enabling the detection of both helical and coccal (non-cultivated) forms of H. pylori.

Helicobacter pylori is detected in approximately 87% of patients with gastric ulcers and 75% of patients with acute gastritis. Primary H. pylori infection occurs in childhood and is asymptomatic, but in some individuals, it can lead to severe disease over time. After entering the stomach, the bacteria migrate chemotactically to sites where urea and hemin are released. By producing the enzyme urease, H. pylori breaks down urea into ammonia and carbon dioxide. Ammonia neutralizes the acidic environment, forming a protective buffer around the bacteria, ensuring their survival in the low pH of the stomach.

The bacterium exhibits multifactorial aggressiveness:

• produces cytopathic toxins that can directly damage the epithelium;
• produces proteolytic enzymes that destroy the mucosal barrier;
• reduces the hydrophobic properties of the epithelium due to lipase activity;
• high ammonia levels disrupt the integrity of the cellular layer.

Although H. pylori activity is limited to the gastric mucosa, its presence in the duodenum is possible with gastric metaplasia, which often accompanies peptic ulcer disease.

Given the aggressive action of the bacterium on the gastric mucosa and its proven association with the development of gastritis, peptic ulcer disease, epithelial malignancy, and vitamin B12 deficiency, timely diagnosis of H. pylori is key to effective treatment and the prevention of complications. Non-invasive stool PCR testing can accurately detect the infection even in the absence of pronounced symptoms.

When?

• If Helicobacter-associated diseases (chronic gastritis, duodenitis, peptic ulcer) are suspected.
• In case of epigastric discomfort, heartburn, nausea, or bloating after meals.
• Before starting or monitoring the effectiveness of eradication therapy.
• If unexplained anemia or vitamin B12 deficiency is detected.
• In family members of patients diagnosed with H. pylori infection.

Who should consider this test?

• Adults and children with long-term gastrointestinal symptoms.
• Patients with a history of peptic ulcer disease or gastritis.
• Individuals at increased risk of gastric cancer.
• Those who want non-invasive screening without gastroscopy.

• Stool

MATERIAL COLLECTION RULES