Laboratory tests in primary care · by Dr Solange Déplanque and Dr Michaël Rochoy

Helicobacter pylori: test for infection, confirm eradication

Gastroenterology and hepatology · Symptom or situation · updated 2026-10-29

BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.

Frequency: 15 to 30% of the population in France ^[1]

Test for infection

Without digestive symptoms (otherwise gastroscopy straight away)

Helicobacter pylori serology (IgG)
Positive serology: gastroscopy with biopsies (histopathology and, if possible, culture with susceptibility testing).

Detailed explanation and international comparison (in French): read it in English (machine translation)

Do not order

Repeating an H. pylori serology: pointless ^[2]
Breath test, stool antigen or biopsies less than 4 weeks after antibiotics or less than 2 weeks after a PPI: these methods perform less well there, so prefer serology ^[2]
Treating "blindly" without proof of infection: it must have been demonstrated before any eradication treatment ^[4]

Confirm eradication

Fasting sample.

At least 4 weeks after the end of antibiotics and 2 weeks after stopping the PPI

13C-urea breath test (kit bought at a pharmacy, test done fasting at the laboratory)
Helicobacter pylori stool antigen (if the breath test cannot be done)if neededAlternative to the breath test for the eradication check ^[4], now reimbursed in this indication ^[3].

Detailed explanation and international comparison (in French): read it in English (machine translation)

Do not order

Serology to check eradication: antibodies persist for months, even years, after cure ^[2]
Check too early: the breath test performs well only at least 4 weeks after antibiotics and 2 weeks after PPI ^[4]

Sources (9)