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Diagnosing H. pylori Infection
Diagnosing H. pylori Infection

H. pylori Infection.

The Urea Breath Test (UBT) and the H. pylori Stool Antigen test are common tests used to accurately diagnose whether you have an H. pylori infection. Detecting H. pylori is essential in identifying the cause of your symptoms and/or ulcers in the absence of more advanced signs. It is also valuable post-treatment to ensure the infection has been eliminated.

How is the test performed?

Antigen Test – Stool Sample
UBT – Breath Sample


An H. pylori infection of the digestive tract is caused by a type of bacteria called Helicobacter pylori, and although it is a very common infection, it is known to lead to the development of peptic ulcers and other stomach issues in some cases. 

The Urea Breath Test (UBT) and the H. pylori stool antigen test are the two most common tests used to diagnose an infection with Helicobacter pylori (H. pylori). Testing detects an infection of the digestive tract which is essential in identifying the cause of symptoms and/or ulcers in the absence of other more severe features.


The UBT measures the amount of carbon dioxide in the breath before and after drinking a solution containing urea. When the H. pylori bacteria breaks down urea, carbon dioxide gets released, so if the amount of carbon dioxide in your second breath sample is higher than the amount in your first sample, it indicates that an H. pylori infection is present.

H. pylori Stool Antigen Test

The H. pylori stool antigen test looks for substances (called antigens) found in your stool (or feces) that trigger the immune system to fight an H. pylori infection. It is a useful alternative to the Urea Breath Test (UBT).

You should get tested when you have symptoms of an ulcer, such as ongoing indigestion, gastrointestinal pain that comes and goes, unexplained weight loss, nausea and/or vomiting. It is also recommended to get tested again about 4-6 weeks after completing treatment for the infection. 

Most people that have an H. pylori infection do not realize it because they do not experience any signs or symptoms. However, your doctor may order the UBT, or stool antigen test (if the UBT is not available), if you meet the following criteria:

  • You are experiencing the signs and symptoms of a peptic ulcer
  • You are under the age of 60
  • You are in the early stages of disease progression, based on your signs and symptoms, but do not require an endoscopy at this time

To have the UBT completed you will need to schedule an appointment*. Prior to visiting the Patient Service Centre, please ensure you have a completed and signed test requisition from your health care provider as the sample cannot be collected without one.

If the UBT is not available and/or your health care provider has decided you need the stool antigen test completed, you will need to obtain a collection container and provide a stool sample at a LifeLabs Patient Service Centre. Prior to visiting the Patient Service Centre please ensure you have a completed and signed test requisition from your health care provider as samples cannot be accepted without one. In addition, samples should be collected and dropped off at our Patient Service Centres on the same day.

For Ontario patients, both the UBT and stool antigen test are uninsured and will need to be ordered and paid for privately. You can order the stool antigen test online by clicking here. The UBT is not currently available for online purchase.

* In Ontario, appointments for the UBT must be booked by phone by calling 1-877-849-3637

Test results will be provided directly to your doctor for discussion with you. The report will indicate if H. pylori is detected in your breath or stool sample. Results are reported as positive, indicating the presence of an H. pylori infection, or negative, meaning either you do not have an H. pylori infection, or the infection was not detected by the test.


Helicobacter pylori (H. pylori) is a bacteria that is present in half the world’s population. H. pylori infection has a known association with peptic ulcer disease (duodenal and gastric) and chronic active gastritis. The most likely route of infection is either oral-to-oral contact or fecal-to-oral contact.

Urea Breath Test (UBT)

The most accurate, noninvasive method for detecting H. pylori is the UBT. The test is based on the large level of urease that is produced by all H. pylori strains. It is a very reliable test that has been validated in both adults and children. Fasting patients consume a small amount of either 14C- or 13C-labeled urea. As urease degrades, urea labeled carbon dioxide is released into the bloodstream via the gastric mucosa and is detected in a breath sample. Results are reported as positive for an H. pylori infection or negative for the absence of an infection.

For patients undergoing ulcer therapy, the UBT should be offered after 4 to 8 weeks of the eradication treatment. The UBT is recommended in leading society guidelines as a preferred non-invasive choice for detecting H. pylori before and after treatment1

Stool Antigen Test

The H. pylori stool antigen test uses enzyme immunoassay to detect antigen proteins in the patient’s stool sample. The results of this test are reported as H. pylori antigen detected, not detected, or indeterminate. The presence of H. pylori is indicated as a positive result (antigen detected). A negative result (antigen not detected) typically indicates the absence of H. pylori, or possibly, an antigenic level below the immunoassay detection limit.

If your patient has initiated ulcer therapy during the two-week period leading up to specimen collection, a false-negative result is possible. If that occurs, the patient should wait until two weeks after the treatment is completed to have the test redone on a new specimen. If an indeterminate result is reported, retesting with a new specimen will also be required.


The patient must schedule an appointment at a LifeLabs Patient Service Centre to have their breath sample collected*. Patients must present a requisition form signed by a physician or healthcare provider at the time of testing.

* In Ontario, appointments for the UBT must be booked by phone by calling 1-877-849-3637

Stool Antigen Test

The patient must obtain a collection container and provide a stool sample at any of LifeLabs Patient Service Centres. Patients must present a requisition form signed by a physician or healthcare provider. A scheduled appointment time is not required for an H. pylori stool antigen test, the patient simply needs to drop off a stool sample as per the instructions.

Cost in Ontario.

The UBT and stool antigen tests are currently uninsured in Ontario.

The cost for the UBT is $110

The cost for the antigen test is $198

Payment may be made by the patient at LifeLabs Patient Service Centres either at their appointment for the UBT or when dropping off the stool sample for the antigen test. For convenience, Visa, Mastercard and Debit Cards are accepted.

Patients are encouraged to check with their private healthcare insurer to see if coverage is provided.

Cost in British Columbia.

Both tests are covered under the Medical Services Plan (MSP) in British Columbia

Results will be available to you within 8 days.

We have a wealth of medical experts available to support you in interpreting test results.

Consults with our experts are available upon request. 

    Request more information

    Patients do not need to schedule an appointment time for an H. pylori stool antigen test, they simply need to drop off a stool sample as per the instructions, along with a completed requisition from their healthcare provider. Samples not accompanied by a requisition will not be accepted.

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