Lab Test

Helicobacter Pylori Antigen, Stool

Campylobacter pylori, H. pylori, gastritis, Helicobacter pylori Antigen, Stool

Test Codes

EPIC: LAB7094, Beaker: XHPAG, Warde: HELPY


Send Outs


Patients should not take antibiotics, bismuth preparations, or proton pump inhibitors for two weeks prior to testing.

Specimen Collection Criteria

Collect: Random stool specimen (10 grams) in a sterile collection container with no preservatives. (Minimum: 0.5 g).

Also acceptable: Cary-Blair stool culture transport medium.

Physician Office/Draw Specimen Preparation

Maintain specimen (in sterile collection container) frozen (-20°C/-4°F or below) prior to transport.

Cary-Blair specimens may be sent at room temperature (20-26°C or 68-78.8°F).

Preparation for Courier Transport

Transport: Stool in a sterile collection container, frozen (-20°C/-4°F or below). (Minimum: 0.5 g)

Rejection Criteria

  • Rectal swabs.
  • Watery stools.
  • Stool specimens received in transport media or preservative.
  • 24-hour collection of stool.

In-Lab Processing

  • Maintain specimen frozen (-20°C/-4°F or below) prior to testing.
  • Refrigerated specimen acceptable if received within 72 hours.


Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 4 days
Refrigerated (2-8°C or 36-46°F): 4 days
Frozen (-20°C/-4°F or below): 30 days

Room Temperature (20-26°C or 68-78.8°F): 4 days
Refrigerated (2-8°C or 36-46°F): 4 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Specimen retention time is determined by the policy of the reference laboratory. Contact the Send Outs Laboratory with any questions.


Sent to Warde Medical Laboratory, Ann Arbor, MI then forwarded to Quest Diagnostics Nichols Institute, Valencia, CA.


Saturday – Sunday.
Results available 4-6 days.

Reference Range

Negative for H. pylori antigen.

Test Methodology

Enzyme Immunoassay (EIA).


The sensitivity of the assay has been reported to be 89% with a 94-95% specificity.

Antimicrobials, proton pump inhibitors and bismuth preparations are known to suppress H. pylori growth. Ingestion of these agents within two weeks of H. pylori antigen may produce false negative results.

Testing to confirm eradication of H. pylori should be done four or more weeks after completion of therapy.

Clinical Utility

This assay provides a non-invasive method for the identification of Helicobacter pylori in stool. Test results are intended to aid in the diagnosis of H. pylori infection, and to monitor response during and after therapy in adult patients.

Clinical Disease

Nearly 70% of gastric ulcers and more than 90% of duodenal ulcers have been associated with H. pylori infections. H. pylori infection has also been associated with adenocarcinoma of the stomach. Nearly all patients with H. pylori have antral gastritis.


Prevalence of infection increases with age. By 60 years of age, 50% of patients have evidence of H. pylori infection. Despite this high incidence, disease is seen in only a small percentage of this population (less than 2%). African Americans and Hispanics have increased infection rates over non-Hispanic Caucasians. Infection rates are higher in lower socioeconomic areas. Infection is infrequent in childhood.


H. pylori is believed to be transmitted by the fecal-oral route. Enhanced transmission can occur in areas with overcrowded living conditions. Patients with H. pylori infection may develop acute gastritis within two weeks following infection.


  1. Lawson, A.J. 2011. Heliobacter. Manual of Clinical Microbiology, 10th edition. Versalovic, J. et. al. (eds.) ASM Press. Washington, D.C.

CPT Codes



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