Helikit test: definition, indications, procedure

What is the helikit test?

Helicobacter pylori (or H. pylori) is a common bacteria that infects the inner lining of the stomach.describes general practitioner Erik Bernard. “In Europe, 15 to 30% of the population would be infectedbut the frequency varies according to age groups”, he reports. Often acquired during childhood, the infection persists throughout life if left untreated and can lead to inflammation of the stomach (gastritis).

With time, “it can progress to an ulcer of the stomach wall or duodenum, or more rarely to stomach cancer”, notes Dr. Bernard. In terms of numbers, “among those infected, 10% will develop an ulcer and 1% will develop stomach cancer”he emphasizes.

In which cases should a helikit test be performed?

Fortunately, reassures the general practitioner, “when this bacteria (Helicobacter pylori) is found, medical treatment is possible to eliminate it and prevent the occurrence of pathologies” (gastritis, ulcers, cancer).

What are the symptoms and indications of the Helicobacter pylori bacteria?

The indications for looking for the presence of an infection with the Helicobacter pylori bacteria are, according to the HAS (High Authority of Health):

• Gastric ulcer or duodenal (history of ulcer or active ulcer);
• Before taking non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin in the event of a history of gastric or duodenal ulcer;
• Chronic dyspepsia with normal gastroscopy;
• Iron deficiency anemia without cause found or resistant to oral iron treatment.
• Vitamin B12 deficiency without cause found;
• Risk factors for gastric cancer (family history of stomach cancer, patient with digestive cancer predisposition syndrome (HNPCC/Lynch), patient having had a partial gastrectomy or endoscopic treatment of gastric cancer lesions, patient with gastric preneoplastic lesions (severe atrophy and/ or intestinal metaplasia, dysplasia);
• Gastric lymphoma you PAINTED ;
• Patient requiring a bariatric interventionisolating part of the stomach;
• Immunological thrombocytopenic purpura of the adult.

Why take a Helikit test?

According to the Public Health Database for Medicines, the indication for the HELIKIT test is “in vivo diagnosis of Helicobacter pylori (H. pylori) infection, including control of eradication, in adults”. We also talk about “marked urea breath test”. Furthermore, as specified by the High Authority of Health: “This test is based on a specific property of the bacteria: its ability to transform urea into carbon dioxide. It consists of swallowing a labeled urea solution then collecting the exhaled air. If the exhaled air contains carbon dioxide which is also marked, this means that the bacteria has transformed the urea into carbon dioxide and therefore that it is present.

A test to identify the presence of this bacteria in the stomach

Presented in kit form, “this test allows the diagnosis of H. pylori infection (before treatment) and eradication control (after treatment)”, specifies Erik Bernard. But, the kit is only reimbursed for eradication control. “Due to the risk of failure of the eradication treatment (10 to 20% of cases), a control test is essential to check whether the bacteria has been eliminated”he adds.

In practice, “this test is often prescribed following endoscopic exploration (digestive fiberoscopy allowing to see the esophagus and the stomach) having highlighted the presence of H. pyloriin order to ensure its effective disappearance after eradication treatment”he reports.

For patients who do not present digestive symptoms or risk factors for developing cancer, a blood test may be offered as a first-line procedure (serology). “If the result is negative, there is no infection and there is no need to perform endoscopy”assures the general practitioner.

Helikit test, what if the result is positive?

If the serology result is positive, that is to say the presence of the bacteria in the stomach is proven, a fibroscopy with samples will be carried out. “In no case can the presence of H. pylori prejudge a possible pathology associated with H. pylori infection (gastritis, gastric or duodenal ulcer, stomach cancer)”, insists Dr. Bernard. Only an upper digestive endoscopy with biopsies can be used to establish a diagnosis.

Where and how to obtain the Helikit test?

A test under medical prescription

The Helikit test is prescribed by the general practitioner or a gastroenterologist in the event of suspected infection with the Helicobacter pylori bacteria.

Available in pharmacies on prescription

With the medical prescription, the patient collects their Helikit kit from the pharmacy. This is a bottle containing a sachet of powder for oral solution (containing 75 mg of 13C-labeled urea).

Helikit test: price and reimbursement

Produced under medical prescription, the product is reimbursed and covered by health insurance in the indication “eradication control”.

Where is the Helikit test done?

Helikit test: to be carried out in medical analysis laboratories

According to the Public Health Database for Medicines, “The breath test should be performed under the supervision of qualified and trained healthcare professionals in appropriate facilities.” In practice, the test is carried out in a medical analysis laboratory.

How is the Helikit test (for Helicobacter pylori) done?

Helikit 75 mg: Urea breath test

In practice, 200 mL of water is necessary to carry out the test. A collection of exhaled air (by blowing for approximately 15 seconds into 2 tubes) is carried out twice: a first time (T0) then, after swallowing the test solution and respecting a period of 30 minutes (T30).

The performance conditions must be scrupulously respected so that the interpretation of the test is reliable.

Hélikit, a test to be carried out on an empty stomach

The test must be carried out with an empty stomach (no food, drink or tobacco for at least 12 hours) and rest.

Duration of the Helikit test:

In total, it is necessary to plan approximately 45 minutes on site, in the laboratory.

Other conditions are necessary for the Helikit test to run smoothly:

As Erik Bernard reminds us, certain medications must be stopped before the test:

• Medications such as antibiotics should be avoided 4 weeks before the test;
• THE treatments to reduce stomach acid (proton pump inhibitor or PPI) should be discontinued at least two weeks before testing.
• THE antacids and gastrointestinal dressings must be stopped at least 24 hours before testing.

Helikit test: analysis, results and additional examinations

The respiratory samples will then be analyzed by the laboratory. Apart from the marked urea breath test, other examinations may be prescribed and carried out by healthcare professionals in order to monitor the elimination of the infection:

• Performing a new endoscopy after treatment (when necessary): fibroscopy then makes it possible to confirm the elimination of the bacteria.
• Testing for antigen in stools : it can be used instead of the respiratory test, but is not reimbursed by health insurance.

To note, “H. pylori serology (consisting of looking for antibodies indicative of the bacteria) cannot be used to control its elimination. Indeed, the antibodies can persist for a long time in the body after the disappearance of the bacteria”concludes Dr. Erik Bernard.