What can the Helicobacter tell you — and what not?

A Helicobacter pylori test (e.g., stool antigen test or ¹³C-urea breath test) can reliably indicate whether an active infection with the bacterium Helicobacter pylori is present. This is clinically relevant because H. pylori is a major risk factor for peptic ulcers, chronic gastritis, and gastric cancer. However, the test cannot tell you whether you actually have symptoms or tissue damage – many infected individuals remain asymptomatic. It also cannot assess your individual cancer risk, the severity of inflammation, or antibiotic resistance. Those require further procedures like endoscopy with biopsy or resistance testing. Moreover, serology tests cannot distinguish between a current and a past infection. Interpretation must always consider the clinical context. A positive result does not automatically mandate treatment; guidelines recommend eradication only for specific indications. The test is a useful screening tool but not a comprehensive diagnostic for gastrointestinal diseases.