H. pylori test (stool antigen, breath test, biopsy)

What is an H. pylori test?

Helicobacter pylori, or H. pylori, is a bacterium that lives in the mucus lining the stomach. The infection usually causes no illness by itself. Over years, the inflammation it causes can lead to ulcers and, in some people, stomach cancer.

An H. pylori test answers one question: is the bacterium in your stomach now? Four kinds of test are in use, and they do not answer that question equally well:

The 2018 Houston Consensus, a US expert panel, recommends that serology "not be utilized for detection of active H pylori infection". For a biopsy, it asks for two samples each from two parts of the stomach, because the bacteria are not spread evenly.

What it can find, and what it cannot

A breath or stool test finds the bacterium. It does not look at the stomach, so it cannot tell you what the infection has already done.

Who should be tested, and who should not

The American College of Gastroenterology (ACG, US) lists who to test in its 2024 guideline. The 2018 Houston Consensus adds when testing stops helping:

Medicines that can cause a false negative

Some medicines lower the number of bacteria in the stomach without clearing them. A test taken then can read negative while the infection is still there. The two US sources give different hold times for acid reducers:

H. pylori testing in Taiwan

Taiwan's Health Promotion Administration (HPA) offers a one-time H. pylori stool antigen test at ages 45–74, nationwide from 2026-01-01. Taiwan has no population gastroscopy program. Finding and treating the infection is its stomach-cancer strategy instead. Researchers at National Taiwan University Hospital put the infection rate at about 22% in that age group.

New Dawn Health books an H. pylori test in the ways below. Live prices are further down this page:

• A urea breath test on its own. The H Pylori Breath Test is offered at iHope Clinic in Taipei.
• A biopsy during a gastroscopy. The H. pylori Biopsy is an add-on to the Digestive: Upper Endoscopy & Colonoscopy package only. Its listing names a rapid urease test, histology or culture as the lab method.
• A stool antigen test. Whether a partner clinic offers one is something your coordinator confirms.

What happens on the day?

MedlinePlus, the US National Library of Medicine's health site, describes the breath test in these steps:

1. 1
   Before you book

   List every acid reducer, antibiotic and bismuth product from the last month. Ask the doctor who prescribed it whether to pause it before the test.
2. 2
   Before the test

   Whether you need to fast, and for how long, is confirmed by your coordinator when you book.
3. 3
   First breath sample

   You breathe into a container. This sample is the baseline.
4. 4
   Swallow the urea

   You swallow urea that contains a marked form of carbon. H. pylori breaks urea down and releases that carbon as carbon dioxide.
5. 5
   Second breath sample

   A few minutes later you breathe into a second container. More marked carbon than at baseline suggests an infection.

A biopsy is taken during the gastroscopy itself, usually under sedation. Preparation, fasting and sedation are on the gastroscopy and colonoscopy page; your coordinator confirms them for your clinic.

What are the risks?

MedlinePlus lists no known risks for the breath or stool test. The risks of the other routes, and of the result itself:

• Biopsy during a gastroscopy. Throat discomfort, a small chance of bleeding at the biopsy site that usually stops on its own, and a very small chance of a tear.
• Sedation for the gastroscopy. You need someone to take you home. The gastroscopy page covers it.
• A false negative. Recent acid reducers, antibiotics or bismuth can hide an infection.
• A misleading blood test. A positive antibody result can reflect an infection that is long gone.

Results & follow-up after you fly home

When the report arrives, and in which language, is confirmed when you book. What follows depends on the result:

1. 1
   If the result is negative

   You probably do not have the infection. If you were taking a PPI before the test, ask a doctor whether to repeat it later.
2. 2
   If the result is positive

   Take the report to a doctor, in Taiwan or at home. Treatment is a course of antibiotics with an acid reducer, prescribed by that doctor.
3. 3
   Finish the full course

   The ACG 2024 guideline prefers a 14-day regimen when it is unknown which antibiotics the bacteria resist.
4. 4
   Test again to confirm the cure

   The ACG advises a breath, stool or biopsy test at least four weeks after treatment. Houston notes current treatments fail in at least 20% of cases.
5. 5
   Stop once the cure is confirmed

   Houston recommends against further testing after that. Adults in your household may be tested too.
6. 6
   Act on symptoms, whatever the result

   Black stools or vomiting blood still means an emergency call. In Taiwan call 119 (the local equivalent of 911).

Cost and coverage

The live prices further down this page are New Dawn Health's booking prices. What each one covers differs:

• The breath test is booked on its own. Whether a doctor's consultation is included is confirmed when you book.
• The biopsy add-on needs the endoscopy package. The endoscopy package's listing says biopsies the doctor decides to take during the scan are billed separately at the clinic.
• Treatment is separate from the test. Whether medicines can be prescribed at your visit is confirmed when you book.
• Short-term visitors are not covered by Taiwan's National Health Insurance, so screening is self-funded.
• Reimbursement at home is a question for your insurer. Ask before you book whether your plan pays for a test done abroad.