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H pylori tests – what is the best test for H pylori?

There’s quite a lot of confusion regarding the best test for H pylori, and not without reason.

This short blog post and video will help you with the ins and out of H pylori testing so you feel confident that you’re getting accurate data from your test.

There are four different H pylori tests and they all have benefits and drawbacks.

My personal opinion is that a an H pylori stool test is the best, for reasons explained below.

Better still, I typically recommend an H pylori test that looks at many other different reasons for digestive distress.

Here’s a video that helps to deconstruct the best test for H pylori, with added info below.

H pylori blood test

Many medical centres use H pylori blood tests to diagnose H pylori.

Initially, the H pylori blood test is ok, but loses accuracy for re-testing to check whether H pylori has gone.

The blood test does NOT look for H pylori per se.

Instead it looks for your immune system’s response to H pylori be measuring levels of H pylori antibodies.

When the antibodies are high, it’s deemed that your immune system is fighting H pylori.

H pylori blood test drawbacks

If you have had H pylori in the past and gotten rid of it, your blood test can remain positive for months or years afterwards (false positive)

Thus, you cannot be 100% certain that a positive blood test is showing you a current, active H pylori infection.

TIP: It is absolutely NOT recommended that you use a blood test to for re-testing purposes (i.e. to check H pylori has gone).

Furthermore, the blood test relies on your immune system being strong enough to mount a response against H pylori.

Some people’s immune systems weaken over time meaning that a blood test won’t show H pylori antibodies even if the infection is there (false negative result).

TIP: if you have all the hallmark H pylori symptoms, or intuitively feel you are infected, yet your blood test is negative, get a breath test, stool test or endoscopy to double-check.

Finally, a blood test means having a blood draw, which some people don’t enjoy, and which can be inconvenient.

Because of these drawbacks, I don’t think the blood test is the best test for H pylori, but it does help in many cases.

Endoscopy and biopsy for H pylori

During an endoscopy you lie on your side and a thin tube with a light and camera on the end is passed down your esophagus into your stomach.

Your gastro doctor can search for red, inflamed areas in your stomach and duodenum lining (your duodenum is the upper section of your small intestine).

This test is brilliant for identifying stomach and duodenal ulcers and stomach inflammation known as gastritis.

In some cases, especially when you’re getting a little older, the doc may find a condition called atrophic gastritis in which your stomach lining has been eroded away (this needs attention as it’s a risk factor for stomach cancer).

The endoscopy is the only test that can assess the structural health of your upper GI tract.

If your doc suspects H pylori, he or she can take a biopsy, which is a small snip of tissue that’s assessed for the presence of H pylori.

Endoscopy drawbacks

The only real drawbacks to the endoscopy are that it requires a clinic visit and can be an unpleasant experience.

It’s a fairly invasive procedure, which some people really don’t like.

But let’s face it, if you’re feeling really unwell it’s important to find the reason why, especially if it reduces your risk of developing a serious condition.

One final problem with the procedure is that the doc can take tissue snips that don’t contain H pylori, even though H pylori is present (in other words the bugs are hanging out in a place that’s not snipped/biopsied).

I’ve worked with people who had a negative biopsy, but a positive breath or stool test.

Even so, in the medical setting an endoscopy/biopsy is generally considered the gold standard,or best test for H pylori.

H pylori breath test

H pylori reacts with stomach acid to form a gas called urea.

Doctors can analyse your breath for the presence of urea, and when it reaches a certain level they diagnose H pylori.

Unlike the H pylori blood test and endoscopy, the breath test is non-invasive – you don’t have to have anything stuck in you to do the test!

It’s an indirect test, meaning that you’re not actually seeing H pylori in the test.

What you’re seeing is a gas produced by H pylori.

Breath test drawbacks

The breath test is pretty good, but it can lose some accuracy when used with children.

It also loses accuracy if you’re taking PPI medications to block stomach acid production.

Experts recommend you avoid PPI medications for two weeks before taking the test.

As with the tests already mentioned, you need to to travel to a clinic in order to do the test.

But because it’s non-invasive, the breath test is one of the best test for H pylori.

Nonetheless, if you have H pylori symptoms and you get a negative breath test, it’s worth doing a stool test or endoscopy to double check.

H pylori stool test

I’m quite biased because I used stool test to find my own H pylori infection back in 2007.

According to the 2012 Maastricht Consensus, The H pylori stool test is about as accurate as the breath test.

Unfortunately, the medical system in some areas doesn’t offer stool testing for H pylori and some doctors are still unaware it exists.

I feel the stool test is the best test for H pylori for the following reasons.

First, it’s non-invasive – you just need to provide a stool sample and even with a medical test you do it in the privacy of your own home.

Second, it’s accurate.

Third, it can be used for H pylori retesting.

Fourth, stool tests are available through private laboratories meaning that you have some autonomy and flexibility with testing (discussed below).

H pylori stool test drawbacks

Now and again, the H pylori stool test will bring a false negative result, but it’s still very accurate.

Of course, some folk are repulsed by the idea of pooping in a cardboard tray and scraping out a sample (LOL).

BUT, it’s a small price to pay for regaining your health and vitality.

Like the breath test, the H pylori stool test also loses accuracy if you’re taking PPI medications to block stomach acid production.

Experts recommend you avoid PPI medications for two weeks before taking the test.

As with the other tests, if you have H pylori symptoms and you get a negative stool test, it’s worth doing a stool test or endoscopy to double check.

H pylori home stool tests

I’ve written about home stool testing in detail elsewhere, but here are my thoughts in a nutshell.

Private laboratories have developed some truly wonderful home stool tests that offer far more expansive information to help you uncover why you’re feeling lousy.

The single biggest problem with ALL the tests mentioned above is that they only look for H pylori.

Now, if you’ve read some of my other info, you’ll know that H pylori is only one possible reason for digestive symptoms, fatigue, mood problems, skin issues and so on.

What about Candida?

What about small intestinal bacterial overgrowth?

What about parasites such as Blastocystis hominis (the one I had), Giardia and Cryptosporidium?

What about your ability to digest food – stomach acid levels, pancreatic function, liver and gallbladder health?

What about gluten sensitivity?

My point is that H pylori is only the tip of the iceberg but unfortunately the medical system doesn’t consider these other bugs and reasons for symptoms.

If you’re going to go through the messy process of providing a stool sample, why not have the lab check that sample for several dozen things, rather than just H pylori?

Home stool testing has the ability to uncover much, much more and save you a heck of a lot of time and energy trying to figure things out.

In fact, it could be the make or break factor as to whether or not you’re able to recover your wellness.

Check out what home stool testing has to offer here.

Retesting for H pylori

There’s a full blog post and video on H pylori retests here.

Once you’ve completed H pylori treatment (whether herbal or pharmaceutical), it’s wise to wait 4 weeks before getting retested.


Because it gives H pylori a chance to regrow and show up on a test.

Testing too soon may give a false negative because H pylori is still there, it’s ready to spread, but it’s not in high enough numbers when you retest to show a positive result.

DON’T use the blood test for retesting – it’s pretty a waste of time.

DO use a breath test, stool test or endoscopy.

Important considerations for ALL H pylori testing

Please always remember that there isn’t an H pylori test that’s 100% perfect – they ALL have their inaccuracies.

Even the best test for H pylori will fail to find the bacteria occasionally.

Most of the testing these days is pretty accurate, but don’t be fobbed off by anyone telling you their test is perfect.

If your doc tells you categorically that his or her test is 100% accurate, run for the hills – it’s plain ignorance.

As I’ve said several times in this post, if you suspect you have H pylori and your test is negative, do another test.

Or if you want to check for all the other things that could be irritating your gut, do a home stool test that checks lots of things at the same time.

When I recommend home stool testing to people, I typically find 2 or 3 different things that need to be addressed.

Still, I offer a money back guarantee because I KNOW the test may miss something,

So getting a home stool test from us is a no-risk proposition – no findings, no fee.

What’s the best test for H pylori, then?

The answer to this question really depends on what you’re looking to achieve.

If you’re doing your first test, all the tests are good, but they can still miss H pylori.

If you’re running an H pylori retest, avoid the blood test like the plague.

If you want a broader spread of findings, get a home stool test.

Irrespective of which test you do, make sure you consider your foods, eating habits and lifestyle because while people don’t like to admit it, they’re the number one cause of digestive problems.

You can get help with your diet, too, by taking a peek here.

Now it’s your turn…

Do you have an opinion on the best test for H pylori, or have you had trouble with H pylori testing at all?

Join the debate by leaving a comment below.




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