Materiały źródłowe

• #1 Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management Helicobacter pylori Infection: Laboratory Support of Diagnosis

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_Hpylori/helicobacter-pylori-infection-laboratory-support-of-diagnosis-and-management

  Helicobacter pylori infection is a common bacterial infection that causes chronic gastritis. The estimated prevalence of H pylori infection is 36% in the United States and >50% worldwide. Many people with H pylori infection are asymptomatic, but some develop serious gastrointestinal (GI) diseases including peptic ulcer disease, gastric cancer, and gastric mucosa–associated lymphoid tissue (MALT) lymphoma. Diagnosis and treatment of H pylori infection are important because infection is rarely self-limiting. A variety of diagnostic tests can detect infection, including a stool antigen test, urea breath test (UBT), rapid urease test, histology, culture, serology, and others. Serology was previously the most common approach, but it is no longer recommended because of its lower sensitivity and specificity for active infection.

• #2 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  H. pylori tests detect whether you have H. pylori infection a major cause of stomach ulcers and peptic ulcer disease. Four tests can detect signs of the bacteria: breath (urea) tests, stool tests, blood tests and upper endoscopy tests. A positive test result means youll need antibiotics to kill the bacteria and clear the infection. […] Helicobacter pylori (H. pylori) tests show if you have an H. pylori infection. H. pylori is bacteria that infects your stomach or duodenum (the first part of your small intestine). An infection can cause irritation and inflammation in your stomach lining (gastritis) and lead to stomach ulcers and peptic ulcer disease. Infections can increase your risk of stomach (gastric) cancer. […] H. pylori tests allow providers to diagnose these conditions. They can show if treatment has cured the infection.

• #3 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. […] Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies. Molecular methods have been used in variable specimens other than gastric mucosa. More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes.

• #4 Indications and diagnostic tests for Helicobacter pylori infection in adults – UpToDate

  https://www.uptodate.com/contents/indications-and-diagnostic-tests-for-helicobacter-pylori-infection-in-adults

  Indications and diagnostic tests for Helicobacter pylori infection in adults […] Helicobacter pylori is the most prevalent chronic bacterial infection and is associated with peptic ulcer disease, chronic gastritis, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. […] This topic will review the clinical indications for testing for H. pylori, diagnostic tests for H. pylori, and their interpretation. […] Testing for H. pylori should be performed only if the clinician plans to offer treatment for positive results. Indications for testing include gastric marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and active peptic ulcer disease or past history of peptic ulcer if cure of H. pylori infection has not been documented.

• #5 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. […] Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies. Molecular methods have been used in variable specimens other than gastric mucosa. More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes.

• #6

  https://link.springer.com/article/10.1007/s10096-018-3414-4

  Helicobacter pylori (H. pylori) resides in the stomach, colonizes gastric epithelium, and causes several digestive system diseases. […] Several diagnostic methods utilizing invasive or non-invasive techniques with varying levels of sensitivity and specificity are developed to detect H. pylori infection. […] Invasive methods require endoscopy with biopsies of gastric tissues for the histology, culture, and rapid urease test. […] Among non-invasive tests, urea breath test and fecal antigen tests are a quick diagnostic procedure with comparable accuracy to biopsy-based techniques and are methods of choice in the test and treatment setting. […] Other techniques such as serological methods to detect immunoglobulin G antibodies to H. pylori can show high accuracy as other non-invasive and invasive biopsies, but do not differentiate between current or past H. pylori infections.

• #7 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. […] Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies.

• #8 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Various diagnostic methods are developed to detect H. pylori infection and diagnostic tests with both high sensitivity and specificity, exceeding 90%, are necessary for accurate diagnosis of H. pylori infection in clinical practice. Although many diagnostic tests are available now, each method has its own advantages, disadvantages, and limitations. The choice of one method or another could be depended on availability and accessibility of diagnostic tests, level of laboratories, clinical conditions of patients, and likelihood ratio of positive and negative tests on different clinical circumstances. Diagnostic tests are usually divided into invasive (endoscopic-based) and noninvasive methods. Invasive diagnostic tests include endoscopic image, histology, rapid urease test, culture, and molecular methods. Non-invasive diagnostic tests included urea breath test, stool antigen test, serological, and molecular examinations. In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions.

• #9 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  There are four tests for H. pylori. They check your breath, stool (poop), blood or stomach/small intestine lining for signs of the bacteria. […] An H. pylori breath test is the most common test for H. pylori. It measures the amount of carbon dioxide in your breath after you drink a special solution containing urea. H. pylori bacteria break down urea into carbon dioxide. Excess carbon dioxide in your breath is a sign of an H. pylori infection. […] An H. pylori stool antigen test (SAT) detects antigens associated with H. pylori in your poop. An antigen is a protein thats unique to a specific type of cell, virus or bacteria. Theyre markers that allow your immune system (your bodys infection-fighting system) to identify germs. Having H. pylori antigens in your poop means you have the bacteria in your gut.

• #10 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #11 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #12 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method. […] Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in the diagnosis of H. pylori infection.

• #13 Helicobacter pylori (H. pylori) infection – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/h-pylori/diagnosis-treatment/drc-20356177

  Several tests and procedures are used to determine whether you have Helicobacter pylori (H. pylori) infection. Testing is important for detection of Helicobacter pylori (H. pylori). […] Repeat testing after treatment is important to be sure H. pylori is gone. Tests may be done using a stool sample, through a breath test and by an upper endoscopy exam. […] This is the most common stool test to detect H. pylori. The test looks for proteins (antigens) associated with H. pylori infection in the stool. […] A lab test called a stool polymerase chain reaction (PCR) test can detect H. pylori infection in stool. […] During a breath test called a urea breath test you swallow a pill, liquid or pudding that contains tagged carbon molecules. […] If you have H. pylori infection, carbon is released when the solution comes in contact with H. pylori in your stomach.

• #14 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  There are four tests for H. pylori. They check your breath, stool (poop), blood or stomach/small intestine lining for signs of the bacteria. […] An H. pylori breath test is the most common test for H. pylori. It measures the amount of carbon dioxide in your breath after you drink a special solution containing urea. H. pylori bacteria break down urea into carbon dioxide. Excess carbon dioxide in your breath is a sign of an H. pylori infection. […] An H. pylori stool antigen test (SAT) detects antigens associated with H. pylori in your poop. An antigen is a protein thats unique to a specific type of cell, virus or bacteria. Theyre markers that allow your immune system (your bodys infection-fighting system) to identify germs. Having H. pylori antigens in your poop means you have the bacteria in your gut.

• #15 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  The rapid in-office, monoclonal test is widely used and provides significant benefit in terms of availability and speed. However, a study using the test as a reference to compare against a new test found the in-office test to only have a 0.50 sensitivity and 0.96 specificity out of 162 patients (Korkmaz et al., 2015). […] The UBT has also been well-validated. A meta-analysis by Ferwana et al. (2015) including 3999 patients of 23 studies found the diagnostic test to have a pooled sensitivity of 0.96 and a pooled specificity of 0.93. The authors noted that their populations had significant heterogeneity but concluded that the UBT had high diagnostic accuracy for detecting an H. pylori infection (Ferwana et al., 2015). This test is often considered the gold standard for diagnosing an H. pylori infection (Patel et al., 2014).

• #16 Noninvasive Diagnostic Tests for Helicobacter pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p16.html

  Which noninvasive diagnostic test urea breath test, serology, or stool antigen test provides the most accurate diagnosis of Helicobacter pylori infection in symptomatic and asymptomatic patients? […] When compared with serology or stool antigen tests, the urea breath test has the highest diagnostic accuracy to identify H. pylori infection in patients without a history of gastrectomy or recent use of antibiotics or proton pump inhibitors. […] The urea breath test had the highest diagnostic accuracy and lowest false-negative rate for the detection of H. pylori. […] The American College of Gastroenterology (ACG) recommends testing in patients with active peptic ulcer disease, dyspepsia symptoms, and gastric mucosa-associated lymphoid tissue lymphoma, whereas the Maastricht guidelines also include patients starting long-term nonsteroidal anti-inflammatory drugs, those with idiopathic thrombocytopenic purpura, and those who desire testing.

• #17 Testing for Diagnosis of Helicobacter Pylori

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed.

• #18 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Proton pump inhibitors (PPIs) should be stopped two weeks before H. pylori testing, and antibiotics should be stopped four weeks before H. pylori testing. Diagnosis should be based on either: positive culture or H. pylori gastritis on histopathology with at least 1 other positive biopsy-based test. […] The non-invasive diagnostic testing was indicated in children when investigating causes of chronic immune thrombocytopenic purpura or for the assessment of anti-H. pylori therapy at least after four weeks of therapy (L. Jones et al., 2017). […] Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition (JSPGHAN) The JSPGHAN have updated their guidelines for H. pylori testing in pediatrics, including recommendations for diagnostic methods in children. […] For diagnosis using endoscopic biopsy specimens, the guidelines recommend considering the performance and accuracy of the rapid urease test, recommending an additional urea breath test or stool antigen test when there is inconsistency between histopathology and the rapid urease test. The guidelines further recommend histological examination of gastric biopsies, and culture diagnostic tests to diagnose active H. pylori infection (Kato et al., 2020).

• #19 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #20 Current Helicobacter pylori Diagnostics

  https://www.mdpi.com/2075-4418/11/8/1458

  The rapid urease test (RUT) is based on detecting the activity of the H. pylori urease enzyme, which splits the urea test reagent to form ammonia. […] The greatest information about H. pylori can be obtained in isolation cultivations of H. pylori from gastric biopsy specimens. […] The specificity of the method is 100% when performed under optimal conditions; the sensitivity is 76–90%. […] The 13C-UBT is a non-invasive method for the diagnosis of H. pylori based on a simple principle: patients ingest urea labeled with 13C or 14C, and H. pylori produces urease—an enzyme that splits urea into ammonia and 13C-labeled carbon dioxide. […] The stool antigen test (SAT) is based on the direct identification of the bacterium antigen in stools. […] Serologic tests are widely available to diagnose H. pylori; they are non-invasive, rapid, do not require any special equipment, and can be used in screening populations.

• #21 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method. […] Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in the diagnosis of H. pylori infection.

• #22 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Clinical Utility and Validity The stool antigen test has been shown to have strong accuracy. A meta-analysis by Gisbert et al. (2006) focusing on 2499 patients of 22 studies found the diagnostic test to have a sensitivity of 0.94 and a specificity of 0.97. The monoclonal version of the test was shown to be more sensitive than the polyclonal one (0.95 vs 0.83). The authors also evaluated the diagnostic test after eradication of the bacteria in 957 patients of 12 studies. The authors evaluated the antigen test at 0.93 sensitivity and 0.96 specificity post-eradication (Gisbert et al., 2006). […] A new automated LIAISON Meridian H. pylori SA assay, a chemiluminescent immunoassay that uses novel monoclonal antibodies for capture and detection of the H. pylori stool antigen, was evaluated for its clinical performance. Opekun et al. (2020) studied the utility of this assay on 277 patients who tested positive for H. pylori infection from an endoscopy. Comparing histology, culture, and rapid urease test results, the assay delivered a sensitivity of 95.5% and specificity of 97.6%. The authors conclude that LIAISON brings reliable noninvasive testing for H. pylori to the laboratory that is in very good agreement with the current, more invasive biopsy-based methods such as histology, culture, or rapid urease test (Opekun et al., 2020).

• #23 Helicobacter Pylori (H. Pylori) Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/helicobacter-pylori-h-pylori-tests/

  There are different ways to test for an H. pylori infection. The most common tests use samples of your breath or stool. In certain cases, tests are done on a sample of tissue that’s removed from inside your stomach. […] H. pylori tests are used to: Find out if an H. pylori infection is the cause of digestive symptoms; Find out if treatment has cured an H. pylori infection. […] You may need an H. pylori test if you have symptoms of gastritis or an ulcer. These conditions are often caused by H. pylori bacteria. […] If you’ve been treated for an H. pylori infection, you may need testing to see if treatment worked to get rid of all the bacteria. If H. pylori remains in your body, it can grow and cause symptoms again. […] A negative (normal) H. pylori test result means that you probably don’t have an H. pylori infection. A positive test result means that you have an H. pylori infection. Your provider will usually prescribe one or more antibiotics to treat the infection. You will usually take other medicines to relieve your symptoms and help heal your stomach. After you finish your treatment, your provider may order repeat tests to make sure all the H. pylori bacteria is gone.

• #24 H. pylori Test | Helicobacter Pylori Tests | Meridian Bioscience

  https://www.meridianbioscience.com/diagnostics/disease-areas/gastrointestinal/h-pylori/

  H. pylori is 1 of 4 common infections that can lead to cancer- it is preventable with early detection. […] An H. pylori test is essential for accurate diagnosis and early intervention. When an H. pylori test is not conducted and the infection remains untreated, it may lead to the development of chronic gastritis, peptic ulcer disease, and even gastric cancer. […] Early diagnosis with an H. pylori test helps prevent serious complications and ensures timely treatment. This H. pylori test is a simple, non-invasive procedure that provides accurate results for effective medical management. Regular H. pylori testing is recommended for individuals experiencing persistent digestive issues, as an H. pylori test can lead to early intervention and improved gut health. […] Meridian Bioscience provides the complete H. pylori testing solution that aligns with diagnostic standards set by the European Helicobacter and Microbiota Study Group (EHMSG) and Maastricht Consensus Reports and the American College of Gastroenterology (ACG), and other clinical guidelines. Our comprehensive testing menu includes non-invasive tests for active infection like the BreathID urea breath test (UBT) and stool antigen tests, empowering healthcare professionals with accurate tools for diagnosing and managing H. pylori infections.

• #25 Laboratory Lab results are too important to go anywhere else.

  https://www.beaumontlaboratory.com/lab-test-directory/detail?URL=helicobacter-pylori-antigen-stool&itemID=1

  H Pylori Antigen Level, Stool […] 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. […] Testing to confirm eradication of H. Pylori should be done four or more weeks after completion of therapy. […] Antimicrobials, proton pump inhibitors and bismuth preparations are known to suppress H. Pylori growth. Ingestion of these agents within 2 weeks of H. Pylori antigen may produce false negative results.

• #26 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #27 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  An H. pylori blood test detects antibodies associated with an H. pylori infection. Antibodies are proteins your immune system makes if it detects a harmful antigen. The antibodies circulate in your bloodstream to find and destroy the offending germ (like H. pylori). […] A downside of blood tests, compared to the others, is that they cant distinguish between active infections and a past infection thats already cleared. Antibodies can still circulate in your bloodstream after an infection is gone. […] For this reason, providers mostly use blood tests to screen for H. pylori infections in populations where the bacteria are more common. H. pylori is more widespread in Africa, South America and western Asia. […] An upper endoscopy is the most accurate at detecting H. pylori. But unlike the other tests, an endoscopy is invasive. Your provider may perform this test if theyre looking for other issues (like signs of cancer) in addition to H. pylori infection. This test involves using a scope to remove tissue from your stomach or duodenum and testing the sample for H. pylori.

• #28 Helicobacter Pylori (H. Pylori) Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/helicobacter-pylori-h-pylori-tests/

  Blood tests for H. pylori check for certain proteins (antibodies) that your immune system makes to fight off H. pylori. These tests aren’t commonly used to diagnose H. pylori. That’s because the test can’t show whether the antibodies are from an active H. pylori infection that you have now or a past infection that your antibodies successfully fought off.

• #29 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  ELISA-based serological tests are also available for detection of H. pylori. However, serological tests often need validation at the local level, which may not be practical in routine practice. Furthermore, serological tests do not distinguish between past and present infections. Serological tests also have a very low positive predictive value in populations with low or average prevalence, as the antibodies will be detected even after an infection has been treated or naturally resolved. In these low-prevalence areas, a positive serological test is more likely to be a false positive (Lamont, 2022). […] Other tests such as PCR-based tests are infrequently used. The PCR test, despite its high accuracy, is often too expensive for routine use. In fact, nested PCR tests have approached 100% sensitivity and 100% specificity for detection of H. pylori (Singh et al., 2008), but the test may not be widely available and may be of limited use due to high cost (Lamont, 2022; Patel et al., 2014). PCR tests have been used for diagnostic purposes as well as identifying genetic variants of the bacteria and pathogenic genes present in a patient. A variety of body fluids, such as stool and saliva, have been used in PCR tests for this bacterial species (Patel et al., 2014).

• #30 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  ELISA-based serological tests are also available for detection of H. pylori. However, serological tests often need validation at the local level, which may not be practical in routine practice. Furthermore, serological tests do not distinguish between past and present infections. Serological tests also have a very low positive predictive value in populations with low or average prevalence, as the antibodies will be detected even after an infection has been treated or naturally resolved. In these low-prevalence areas, a positive serological test is more likely to be a false positive (Lamont, 2022). […] Other tests such as PCR-based tests are infrequently used. The PCR test, despite its high accuracy, is often too expensive for routine use. In fact, nested PCR tests have approached 100% sensitivity and 100% specificity for detection of H. pylori (Singh et al., 2008), but the test may not be widely available and may be of limited use due to high cost (Lamont, 2022; Patel et al., 2014). PCR tests have been used for diagnostic purposes as well as identifying genetic variants of the bacteria and pathogenic genes present in a patient. A variety of body fluids, such as stool and saliva, have been used in PCR tests for this bacterial species (Patel et al., 2014).

• #31 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  An H. pylori blood test detects antibodies associated with an H. pylori infection. Antibodies are proteins your immune system makes if it detects a harmful antigen. The antibodies circulate in your bloodstream to find and destroy the offending germ (like H. pylori). […] A downside of blood tests, compared to the others, is that they cant distinguish between active infections and a past infection thats already cleared. Antibodies can still circulate in your bloodstream after an infection is gone. […] For this reason, providers mostly use blood tests to screen for H. pylori infections in populations where the bacteria are more common. H. pylori is more widespread in Africa, South America and western Asia. […] An upper endoscopy is the most accurate at detecting H. pylori. But unlike the other tests, an endoscopy is invasive. Your provider may perform this test if theyre looking for other issues (like signs of cancer) in addition to H. pylori infection. This test involves using a scope to remove tissue from your stomach or duodenum and testing the sample for H. pylori.

• #32 Helicobacter Pylori Infection Testing – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/100_199/0177.html

  The stool antigen test (HpSA, Meridian Bioscience, Cincinnati, OH) and the urea breath tests (UBT (Meretek Diagnostics, Lafayette, CO), PYtest (Halyard Health, Alpharetta, GA)) determine the presence of active H. pylori infection. […] According to guidelines from the American Gastroenterological Association (2005) and the American College of Gastroenterology (2007, 2017), urea breath testing or stool antigen testing are the non-invasive methods of choice for detecting new infection in younger patients without alarm symptoms. […] The stool antigen test and the urea breath test are also the tests of choice in those situations where post-treatment testing is required. […] H. pylori serology is no longer recommended by the American Gastroenterological Association (AGA) and American College of Gastroenterology (ACG) as it is not a test of active infection.

• #33 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #34 Helicobacter Pylori Infection Workup: Approach Considerations, Laboratory Studies, Other Tests

  https://emedicine.medscape.com/article/176938-workup

  Imaging studies are generally not helpful in the diagnosis of H pylori infection. […] In patients with prior peptic ulcer disease, an esophagogastroduodenoscopy (EGD) with biopsy and histological studies may be performed. […] Biopsy sampling of both the antrum and corpus is required for histologic accuracy in the evaluation of gastritis. […] A rapid urease test may demonstrate the presence of H pylori in the gastric mucosa obtained by endoscopic mucosal biopsy. […] Although a staging system for the H pylori infection does not exist, some steps in the disease process are well described. […] The risk of gastric cancer is correlated with the severity and extent of atrophic gastritis; histologic staging systems can aid in risk stratification (eg, the operative link for gastritis assessment [OLGA] and operative link for gastric intestinal metaplasia assessment [OLGIM] staging systems).

• #35 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #36 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions. […] Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. […] Antrum is a preferential biopsy site for detecting H. pylori infection in most circumstances, but corpus biopsy from greater curve is suggested for patients with antral atrophy or intestinal metaplasia to avoid false negative results. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori.

• #37 What Is New in Helicobacter pylori Diagnosis. An Overview

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8152493/

  The examination of gastric mucosal biopsy specimens remains the gold standard for the detection of H. pylori, with a sensitivity of 95% and a specificity of 98%. In addition, it enables the visualization of gastric morphology at any time. However, in order to obtain an accurate diagnosis, two antral biopsies, one from the gastric angulus, and two biopsies from the corpus, are necessary. […] Upper endoscopy also allows to collect biopsy specimens for urease testing. The method takes advantage from the presence of pre-formed urease by the organism and, in media containing urea, the enzyme releases ammonia, increasing the pH and resulting in a color change of the medium. The urease test is rapid (RUT), easy to perform, highly specific, and inexpensive for H. pylori diagnosis. However, RUT requires a high density of bacteria, for example, in the standard commercial kits, at least a 104 bacterial load in the gastric specimens is required.

• #38 Helicobacter Pylori Infection Workup: Approach Considerations, Laboratory Studies, Other Tests

  https://emedicine.medscape.com/article/176938-workup

  Imaging studies are generally not helpful in the diagnosis of H pylori infection. […] In patients with prior peptic ulcer disease, an esophagogastroduodenoscopy (EGD) with biopsy and histological studies may be performed. […] Biopsy sampling of both the antrum and corpus is required for histologic accuracy in the evaluation of gastritis. […] A rapid urease test may demonstrate the presence of H pylori in the gastric mucosa obtained by endoscopic mucosal biopsy. […] Although a staging system for the H pylori infection does not exist, some steps in the disease process are well described. […] The risk of gastric cancer is correlated with the severity and extent of atrophic gastritis; histologic staging systems can aid in risk stratification (eg, the operative link for gastritis assessment [OLGA] and operative link for gastric intestinal metaplasia assessment [OLGIM] staging systems).

• #39 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #40 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method. […] Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in the diagnosis of H. pylori infection.

• #41 Current Helicobacter pylori Diagnostics

  https://www.mdpi.com/2075-4418/11/8/1458

  The rapid urease test (RUT) is based on detecting the activity of the H. pylori urease enzyme, which splits the urea test reagent to form ammonia. […] The greatest information about H. pylori can be obtained in isolation cultivations of H. pylori from gastric biopsy specimens. […] The specificity of the method is 100% when performed under optimal conditions; the sensitivity is 76–90%. […] The 13C-UBT is a non-invasive method for the diagnosis of H. pylori based on a simple principle: patients ingest urea labeled with 13C or 14C, and H. pylori produces urease—an enzyme that splits urea into ammonia and 13C-labeled carbon dioxide. […] The stool antigen test (SAT) is based on the direct identification of the bacterium antigen in stools. […] Serologic tests are widely available to diagnose H. pylori; they are non-invasive, rapid, do not require any special equipment, and can be used in screening populations.

• #42 What Is New in Helicobacter pylori Diagnosis. An Overview

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8152493/

  The examination of gastric mucosal biopsy specimens remains the gold standard for the detection of H. pylori, with a sensitivity of 95% and a specificity of 98%. In addition, it enables the visualization of gastric morphology at any time. However, in order to obtain an accurate diagnosis, two antral biopsies, one from the gastric angulus, and two biopsies from the corpus, are necessary. […] Upper endoscopy also allows to collect biopsy specimens for urease testing. The method takes advantage from the presence of pre-formed urease by the organism and, in media containing urea, the enzyme releases ammonia, increasing the pH and resulting in a color change of the medium. The urease test is rapid (RUT), easy to perform, highly specific, and inexpensive for H. pylori diagnosis. However, RUT requires a high density of bacteria, for example, in the standard commercial kits, at least a 104 bacterial load in the gastric specimens is required.

• #43 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed (Lamont, 2022). […] Dechant et al. (2020) evaluated the accuracy of various rapid urease tests (RUTs) and compared it with histopathology results. No differences were detected in the sensitivity or specificity of the various RUTs and RUTs had comparable results to histology; however, in patients treated with proton pump inhibitors and antibiotics. RUTs seemed to be more sensitive compared to histology. Pohl et al. (2019) discuss the drawbacks of RUTs, including false negative test results if the bacterial load is less than 104 in the gastric biopsy and false positive test results with some urease positive bacteria, affecting the sensitivity and specificity of RUTs. Commercially available RUTs, such as HpFast, CLOTest, and HpOne, have reported specificities ranging from 95% to 100%, but their sensitivity is moderate (85% to 95%) (Pohl et al., 2019).

• #44 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  Helicobacter pylori (H. pylori) is a major human pathogen which causes progressive gastroduodenal damage. The rapid urease test (RUT) is a popular diagnostic test in that it is a rapid, cheap and simple test that detects the presence of urease in or on the gastric mucosa. The sensitivity and specificity are generally high and many versions have been approved for use in humans. Best results are obtained if biopsies are obtained from both the antrum and corpus. […] A negative test should not be used as the criteria for cure or in cases where accuracy is important for patient management such as in upper gastrointestinal bleeding. […] The test can also be used to provide an informal assessment of the accuracy of the histopathology result and discrepancies should prompt a review of the histopathology and discussions with the pathologist.

• #45 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is an indirect test of the presence of H. pylori based on the presence of urease in or on the gastric mucosa. It has an advantage over serology in that it only detects the presence of an active infection. […] The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%. […] The two most common reasons for false negative results are the recent use of proton pump inhibitors and the presence of intestinal metaplasia. […] It has also been recommended that RUT should not be used as the sole arbiter of the results of H. pylori eradication therapy because the sensitivity of the RUT is not 100% and thus a negative test does not fully exclude the presence of an active infection.

• #46 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is best considered as a screening test and not as the gold standard for H. pylori infection. […] False negative tests are more frequent than false positive tests and thus a negative result should not be used to exclude H. pylori when a wrong diagnosis would be detrimental to patient management. […] A positive culture is considered the only true gold standard for the diagnosis of H. pylori such that additional testing is needed when one suspects a false-negative result.

• #47 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #48 Current Helicobacter pylori Diagnostics

  https://www.mdpi.com/2075-4418/11/8/1458

  The rapid urease test (RUT) is based on detecting the activity of the H. pylori urease enzyme, which splits the urea test reagent to form ammonia. […] The greatest information about H. pylori can be obtained in isolation cultivations of H. pylori from gastric biopsy specimens. […] The specificity of the method is 100% when performed under optimal conditions; the sensitivity is 76–90%. […] The 13C-UBT is a non-invasive method for the diagnosis of H. pylori based on a simple principle: patients ingest urea labeled with 13C or 14C, and H. pylori produces urease—an enzyme that splits urea into ammonia and 13C-labeled carbon dioxide. […] The stool antigen test (SAT) is based on the direct identification of the bacterium antigen in stools. […] Serologic tests are widely available to diagnose H. pylori; they are non-invasive, rapid, do not require any special equipment, and can be used in screening populations.

• #49 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #50

  https://link.springer.com/article/10.1007/s00508-018-1356-6

  The SAT can be used for the initial diagnosis of H. pylori infection, and for confirming eradication after the treatment. […] Serological testing is used to determine the titer of IgG anti-H. pylori antibodies in the patients serum. […] Endomicroscopy is a novel technique which allows ultra-high magnification in real time. […] The RUT is invasive but cheap, rapid and with specificity above 95%. […] Histology is still considered to be the gold standard for direct diagnosis of H. pylori infection. […] Isolation of H. pylori is performed by cultivation of gastric biopsy specimens using selective media such as Pylori agar, Columbia agar with horse blood and antibiotic supplement and other similar media. […] Molecular methods, most often amplification of nucleic acid by conventional polymerase chain reaction (PCR) or real-time PCR are being increasingly more used to detect H. pylori DNA in biopsy samples or other types of specimens, like saliva or feces.

• #51 Helicobacter Pylori Infection Workup: Approach Considerations, Laboratory Studies, Other Tests

  https://emedicine.medscape.com/article/176938-workup

  Patients with new peptic ulcer disease should have a carbon 13 UBT, they should be tested for antibody titers, or they may require an investigation for stool antigens. […] This novel rapid test is based on monoclonal antibody immunochromatography of stool samples. […] The carbon 13 UBT is based on the detection of the products created when urea is split by the organism. […] The breath test is expensive but is becoming increasingly more available. […] The serology test has a high (90%) specificity and sensitivity. […] It is useful for detecting a newly infected patient, but it is not a good test for follow-up of treated patients because the results do not indicate present infection with H pylori. […] In geographic areas with a high resistance rate against metronidazole and clarithromycin, culture for antibiotic susceptibility testing (antibiogram) seems to be useful.

• #52 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #53

  https://link.springer.com/article/10.1007/s10096-018-3414-4

  Polymerase chain reaction (PCR) is an emerging option that can be categorized as invasive and non-invasive tests. […] Despite the availability of multiple diagnostic methods, it remains unclear on the choice of any one method as the gold standard for detecting H. pylori infection, especially in epidemiological studies. […] In this work, we review the principal diagnostic methods used to detect H. pylori infection and their advantages and disadvantages, and applications in clinical practice.

• #54 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  ELISA-based serological tests are also available for detection of H. pylori. However, serological tests often need validation at the local level, which may not be practical in routine practice. Furthermore, serological tests do not distinguish between past and present infections. Serological tests also have a very low positive predictive value in populations with low or average prevalence, as the antibodies will be detected even after an infection has been treated or naturally resolved. In these low-prevalence areas, a positive serological test is more likely to be a false positive (Lamont, 2022). […] Other tests such as PCR-based tests are infrequently used. The PCR test, despite its high accuracy, is often too expensive for routine use. In fact, nested PCR tests have approached 100% sensitivity and 100% specificity for detection of H. pylori (Singh et al., 2008), but the test may not be widely available and may be of limited use due to high cost (Lamont, 2022; Patel et al., 2014). PCR tests have been used for diagnostic purposes as well as identifying genetic variants of the bacteria and pathogenic genes present in a patient. A variety of body fluids, such as stool and saliva, have been used in PCR tests for this bacterial species (Patel et al., 2014).

• #55 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Serological tests to assess infection have also been used. A meta-analysis by Loy et al. (1996) focused on commercial serological kits assessing H. pylori. Loy et al. (1996) found these kits to have a pooled sensitivity of 0.85 and specificity of 0.79. The authors concluded that there was no major difference in accuracy between any of the kits tested (Loy et al., 1996). […] As costs of sequencing decreases, use of Next Generation Sequencing (NGS) to detect H. pylori infection and its antibiotic resistance has increased. In a study by Nezami et al. (2019), 133 H. pylori positive specimens from histological evaluation were analyzed by NGS to detect mutations in gyrA, 23S rRNA, and 16s rRNA genes. NGS detected H. pylori in 126/133 cases (95% sensitivity). NGS also detected multiple mutations associated with resistance in 92 cases (73%), one mutation in 63 cases (50%), and mutations in several genes in 29 cases (23%). In the 58 cases where treatment history was available, therapy failure was observed in cases where the number of mutated genes was high. Therapy failed in 11/16 cases with multiple gene mutations and 5/27 cases with one gene mutation (Nezami et al., 2019).

• #56 Advances in Diagnostic Modalities for Helicobacter pylori Infection

  https://www.mdpi.com/2075-1729/14/9/1170

  Advances in Diagnostic Modalities for Helicobacter pylori Infection […] Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. […] Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. […] Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. […] Various diagnostic methods, both invasive and non-invasive, are available for detecting H. pylori infection. […] Non-invasive diagnostic methods have been developed and are now widely used. These non-invasive methods fall into three primary categories: serological assays, stool antigen tests, or urea breath tests. […] The H. pylori stool antigen (HpSA) test offers a distinct advantage over other commonly used diagnostic methods by detecting the presence of the bacterium itself rather than antibodies produced in response to it. […] According to various studies and the International Consensus Report, both the urea breath test (UBT) and stool antigen test are regarded as first-line diagnostic methods, with sensitivity and specificity exceeding 90%. […] The urea breath test (UBT) is another widely available diagnostic tool with high sensitivity and specificity, typically ranging from 90% to 100%. […] These diagnostic modalities include collecting mucosal specimens through endoscopic biopsy, histological examination, bacterial cultures, a rapid urease test, and PCR-based analyses. […] Advances in molecular biology have led to the development of highly accurate diagnostic tools for detecting H. pylori infection. […] The Campylobacter-like organism (CLO) test depends on the organism’s production of urease. […] Recognition of H. pylori as the leading player in several gastroduodenal diseases has contributed to the growing demand for its diagnosis. […] Recent advances in H. pylori detection have focused on improving non-invasive methods, enhancing molecular techniques, and utilizing novel technologies.

• #57 Diagnosis of Helicobacter pylori infection: Progress and challenges | Enfermedades Infecciosas y Microbiología Clínica

  https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-diagnosis-helicobacter-pylori-infection-progress-S0213005X20302986

  In the near future, it is probable that next generation sequencing (NGS) could be included to the routine. […] Whole-genome sequencing of H. pylori would allow to identify all possible resistance mutations associated to therapeutic failure, characterize the virulence of the strain and its possible clinical outcome, and to perform molecular epidemiological studies. […] All these exciting questions will broaden the field of Clinical Microbiology in a next future.

• #58 Advances in Helicobacter pylori Diagnosis and Management: Overcoming Resistance and Enhancing Treatment | Meridian Bioscience

  https://www.meridianbioscience.com/diagnostics-blog/unveiling-h-pylori-trends-updates-on-diagnosis-and-management/

  Serological Testing: While testing for H. pylori antibodies through blood or serum (such as H. pylori IgG detection) provides insights into exposure, its role in diagnosing active infection is limited due to the inability to distinguish between past and present infections. […] Molecular Testing: The use of H. pylori test kits that utilize polymerase chain reaction (PCR) for H. pylori DNA or RNA detection is on the rise. These tests offer the promise of detecting antibiotic resistance genes directly from stool samples or biopsy specimens, guiding more targeted therapy. […] The landscape of H. pylori diagnosis and management is evolving rapidly, driven by technological advancements and a deeper understanding of the bacteriums behavior and resistance mechanisms. The trend towards more precise diagnostics, tailored treatment regimens, and the exploration of non-antibiotic therapies reflects a comprehensive approach to tackling H. pylori infection.

• #59 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Various diagnostic methods are developed to detect H. pylori infection and diagnostic tests with both high sensitivity and specificity, exceeding 90%, are necessary for accurate diagnosis of H. pylori infection in clinical practice. Although many diagnostic tests are available now, each method has its own advantages, disadvantages, and limitations. The choice of one method or another could be depended on availability and accessibility of diagnostic tests, level of laboratories, clinical conditions of patients, and likelihood ratio of positive and negative tests on different clinical circumstances. Diagnostic tests are usually divided into invasive (endoscopic-based) and noninvasive methods. Invasive diagnostic tests include endoscopic image, histology, rapid urease test, culture, and molecular methods. Non-invasive diagnostic tests included urea breath test, stool antigen test, serological, and molecular examinations. In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions.

• #60 Current Helicobacter pylori Diagnostics

  https://www.mdpi.com/2075-4418/11/8/1458

  Molecular diagnostic methods are based on the amplification of nucleic acid using a conventional polymerase chain reaction (PCR) or PCR in real time (RT-PCR). […] The high prevalence and etiopathogenetic relationship of H. pylori with the most significant diseases of the stomach highlights the need to optimize the diagnosis of this infection, taking into account the sensitivity and specificity of the tests, as well as the conditions for their use.

• #61 Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html

  The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). […] The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger than 55 years and the absence of alarm symptoms. […] Urea breath tests and stool antigen tests are most accurate for identifying H. pylori infection and can be used to confirm cure; serologic tests are a convenient but less accurate alternative and cannot be used to confirm cure. […] The American College of Gastroenterology (ACG) recommends testing for H. pylori infection in patients with active PUD or history of PUD, dyspepsia symptoms, or gastric MALT lymphoma. […] The test-and-treat strategy for detecting H. pylori is appropriate in patients with dyspepsia and low risk of gastric cancer (age younger than 55 years and no alarm symptoms such as unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of gastrointestinal cancer, overt gastrointestinal bleeding, abdominal mass, iron deficiency anemia, or jaundice).

• #62 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  In patients with uninvestigated dyspepsia who are under the age of 60 years and without alarm features, non-endoscopic testing for H. pylori infection is a consideration. Those who test positive should be offered eradication therapy. […] When upper endoscopy is undertaken in patients with dyspepsia, gastric biopsies should be taken to evaluate for H. pylori infection. Infected patients should be offered eradication therapy. […] Patients with typical symptoms of gastroesophageal reflux disease (GERD) without history of PUD need not be tested for H. pylori infection. For those who are found to be infected, treatment should be offered, acknowledging that effects on GERD symptoms are unpredictable. […] In patients taking long-term low-dose aspirin, testing for H. pylori infection could be considered.

• #63 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  In patients with newly diagnosed H. pylori infection without prior treatment, the differentiation between past or present infection is not relevant. Therefore, serologic tests are appropriate in the initial workup of the patient. In a patient with a prior history of treated H. pylori with recurrent symptoms, a serologic test will not be informative. Therefore either UBT or fecal antigen testing may be performed to diagnose a recurrence of H. pylori infection. […] 2. UBT or Fecal Antigen Testing to Confirm Eradication of H. pylori at the Conclusion of Therapy […] Eradication rates of H. pylori after antibiotic therapy vary from 80% to 90%. Since the purpose of this therapy is to eliminate H. pylori to decrease the ulcer recurrence rate, there has been interest in documenting eradication. In this setting, the breath testing or fecal antigen testing is appropriate to determine active infection. Prior to these technologies, confirmation of organism eradication required repeat endoscopic evaluation to obtain gastric antral biopsy specimens for histology of the CLO test. In most cases, it is unnecessary to document bacterial eradication with follow-up testing; monitoring of clinical symptoms is sufficient. However, patients with persistent symptoms after therapy and those at high risk for recurrence, such as patients with ulcers complicated by bleeding or perforation, may benefit from this testing to determine the necessity for additional anti-H. pylori therapy.

• #64 Helicobacter pylori (H. pylori) infection – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/h-pylori/diagnosis-treatment/drc-20356177

  A health care provider may conduct a scope test, known as an upper endoscopy exam. […] Your provider may also take tissue samples (biopsy). These samples are examined for H. pylori infection. […] Health care providers may use this test for additional testing and to look for other digestive conditions. […] They may also use this test to determine exactly which antibiotic may be best to treat H. pylori infection, especially if the first antibiotics tried didn’t get rid of the infection. […] Repeat testing for H. pylori at least four weeks after your treatment is recommended. If the tests show the treatment didn’t get rid of the infection, you may need more treatment with a different combination of antibiotics.

• #65 Indications and diagnostic tests for Helicobacter pylori infection in adults – UpToDate

  https://www.uptodate.com/contents/indications-and-diagnostic-tests-for-helicobacter-pylori-infection-in-adults

  Indications and diagnostic tests for Helicobacter pylori infection in adults […] Helicobacter pylori is the most prevalent chronic bacterial infection and is associated with peptic ulcer disease, chronic gastritis, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. […] This topic will review the clinical indications for testing for H. pylori, diagnostic tests for H. pylori, and their interpretation. […] Testing for H. pylori should be performed only if the clinician plans to offer treatment for positive results. Indications for testing include gastric marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and active peptic ulcer disease or past history of peptic ulcer if cure of H. pylori infection has not been documented.

• #66 Testing for Diagnosis of Helicobacter Pylori

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Testing for Diagnosis of Helicobacter Pylori – CAM 271 […] Helicobacter pylori (H. pylori) is a spiral-shaped, gram-negative bacteria that thrives while living in acidic environments, growing in close association with the stomach lining. H. pylori infection causes chronic inflammation (infection) in the stomach and is associated with conditions such as peptic ulcer disease, chronic gastritis, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue (MALT) lymphoma. […] For individuals who are 18 years of age and older, urea breath testing or stool antigen testing to diagnose an H. pylori infection is considered MEDICALLY NECESSARY in any of the following situations: For individuals with dyspepsia. For individuals with active peptic ulcer disease (PUD). For individuals with past PUD and who have had recurrent symptoms. For individuals with low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. For individuals with a history of resection of early gastric cancer (EGC). For individuals with gastric intestinal metaplasia (GIM). For individuals initiating chronic treatment with or who have been on a long-term aspirin or non-steroidal anti-inflammatory drug (NSAID) treatment. For individuals with unexplained iron deficiency anemia. For individuals with idiopathic thrombocytopenic purpura (ITP). For individuals with a family history of gastric cancer. For individuals who are first-generation immigrants from a high prevalence area.

• #67 Testing for H. pylori: Which Patients, Which Test, How to Treat? – Fitzgerald Health Education Associates

  https://www.fhea.com/resource-center/testing-for-h-pylori-which-patients-which-test-how-to-treat/

  The UBT involves drinking urea that is labeled with the nonradioactive isotope carbon-13. If H. pylori is present, its urease will split the carbon-13-labeled urea to produce ammonia and carbon-13-labeled carbon dioxide, which is expired in the breath and measured in a postingestion breath sample. […] UBT offers the advantages of measuring active infection and having a sensitivity and specificity of 95%. […] The FAT identifies H. pylori antigen in a stool sample by enzyme immunoassay with the use of polyclonal or monoclonal antibodies. As with the UBT, a positive result provides definitive evidence of active infection. […] Clinicians should test for H. pylori only when they intend to offer treatment for positive results. According to ACG guidelines, the following are established indications for diagnosis and treatment of H. pylori infection: Active peptic ulcer disease (gastric or duodenal ulcer) or confirmed history of peptic ulcer disease (not previously treated for H. pylori infection), Gastric mucosa-associated lymphoid tissue (MALT) lymphoma (low-grade), After endoscopic resection of early gastric cancer, Uninvestigated dyspepsia (depending upon H. pylori prevalence).

• #68 Testing for H. pylori: Which Patients, Which Test, How to Treat? – Fitzgerald Health Education Associates

  https://www.fhea.com/resource-center/testing-for-h-pylori-which-patients-which-test-how-to-treat/

  The ACG’s most recent H. pylori treatment guideline extends the list of potential indications for testing to include patients initiating long-term nonsteroidal anti-inflammatory drug therapy, those starting prophylactic low-dose aspirin, those with unexplained iron deficiency anemia despite an appropriate evaluation, and adults with idiopathic thrombocytopenic purpura. […] The test-and-treat strategy (noninvasive testing with UBT or FAT followed by treatment with a recommended oral regimen for those with a positive result) is recommended for patients with uninvestigated dyspepsia who are younger than 60 years and who do not have ALARMS findings. […] Patients who test positive for H. pylori infection are offered eradication therapy, which typically includes two antibiotics plus a PPI and/or a bismuth preparation.

• #69 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #70 Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management Helicobacter pylori Infection: Laboratory Support of Diagnosis

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_Hpylori/helicobacter-pylori-infection-laboratory-support-of-diagnosis-and-management

  For all types of H pylori tests, positive results indicate H pylori infection. Guidelines indicate that all patients with positive results be offered H pylori eradication therapy. Therefore, diagnostic testing for H pylori should only be performed if the clinician plans to offer treatment to patients who receive positive results. […] Treatment success should be assessed by follow-up testing with a nonendoscopic test, such as UBT or a stool antigen test, or a biopsy-based test if an endoscopy is indicated. Testing should be performed at least 4 weeks after completing eradication therapy. This approach allows any remaining H pylori to recover and repopulate the stomach in sufficient numbers to be detected reliably. Detection of H pylori following eradication therapy indicates recurrence or ineffective treatment.

• #71 Helicobacter pylori – Wikipedia

  https://en.wikipedia.org/wiki/Helicobacter_pylori

  Proton-pump inhibitors and antibiotics should be discontinued for at least 30 days prior to testing for H. pylori infection or eradication, as both agents inhibit H. pylori growth and may lead to false negative results. Testing to confirm eradication is recommended 30 days or more after completion of treatment for H. pylori infection. H. pylori breath testing or stool antigen testing are both reasonable tests to confirm eradication. H. pylori serologic testing, including IgG antibodies, are not recommended as a test of eradication as they may remain elevated for years after successful treatment of infection. […] An endoscopic biopsy is an invasive means to test for H. pylori infection. Low-level infections can be missed by biopsy, so multiple samples are recommended. The most accurate method for detecting H. pylori infection is with a histological examination from two sites after endoscopic biopsy, combined with either a rapid urease test or microbial culture. Generally, repeating endoscopy is not recommended to confirm H. pylori eradication, unless there are specific indications to repeat the procedure.

• #72 Helicobacter Pylori Infection Testing – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/100_199/0177.html

  The American College of Gastroenterology no longer recommends serology for detection of H. pylori infection. […] Guidelines from the American College of Gastroenterology indicate post-treatment testing in all patients treated for H. pylori infection (ACG, 2007). […] Stool antigen testing and urea breath test are the recommended modalities for confirming eradication of H. pylori after treatment. […] According to ACG guidelines, all persons suspected of having peptic ulcer disease should be tested for H. pylori regardless of whether they are on non-steroidal anti-inflammatory drugs (NSAIDS). […] According to guidelines from the American Society for Gastrointestinal Endoscopy (ASGE, 2008), 30-40% of patients undergoing bariatric surgery are infected with H. pylori. […] Updated guidelines from the American College of Gastroenterology (Chey et al, 2017) add the following conditions to the list of indications for H. pylori testing:

• #73 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  For diagnosis without endoscopic biopsy specimens, the guidelines recommend 13C-urea breath test and stool antigen tests. To increase the diagnosis accuracy, the guidelines recommend more than two tests (two noninvasive tests or a biopsy-based and a noninvasive test) be completed. The guidelines recommend urea breath test or stool antigen test four or more weeks after treatment to confirm eradication of H. pylori and recommend against using endoscopic biopsy methods and single serological tests to confirm eradication. The guidelines also recommend against anti-H. pylori antibody tests as a single test to diagnose H. pylori in a clinical setting (Kato et al., 2020). […] Maastricht V/Florence Consensus Report This report was published in 2017 on behalf of the European Helicobacter and Microbiota Study Group and Consensus panel. The panel reports that UBT is the most investigated and best recommended non-invasive test in the context of a test-and-treat strategy. The panel also notes that monoclonal tests can be used and that serological tests can be used only after validation. However, rapid office serology tests are not recommended and should be avoided. The guidelines recommend the rapid urease test (RUT) as a first line diagnostic test if there is an indication for endoscopy and no contraindication for biopsy. The guideline state that H. pylori is linked to unexplained iron deficiency anaemia (IDA), idiopathic thrombocytopenic purpura, and vitamin B12 deficiency, and in these disorders, an H. pylori infection should be sought and eradicated. The guidelines state that PPIs should be stopped two weeks and antibiotics and other bismuth compounds should be stopped 4 weeks before testing for H. pylori. In cases of chronic (active) gastritis in which H. pylori is not detected by histochemistry, immunohistochemical testing of H. pylori can be used as an ancillary test. If histology is normal, no immunohistochemical staining should be performed. It is recommended to perform clarithromycin susceptibility testing when a standard clarithromycin-based treatment is considered as the first-line therapy, except in populations or regions with well documented low clarithromycin resistance (15%). Pepsinogen (Pg) serology is considered the most useful non-invasive test to explore gastric mucosa status (non-atrophic vs atrophic). The PgI/PgII ratio can never be assumed as a biomarker of gastric neoplasia. UBT is the best option for confirmation of H. pylori eradication and monoclonal SAT is an alternative. It should be performed at least four weeks after completion of therapy (Malfertheiner et al., 2017).

• #74 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #75 Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management Helicobacter pylori Infection: Laboratory Support of Diagnosis

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_Hpylori/helicobacter-pylori-infection-laboratory-support-of-diagnosis-and-management

  Assessment of H pylori antimicrobial susceptibility can assist treatment selection after persistent infection. After 2 failed treatments with confirmed patient adherence, the American Gastroenterological Association advises consideration of H pylori susceptibility testing to guide selection of subsequent treatment regimens.

• #76 Testing for Diagnosis of Helicobacter Pylori

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  For all individuals who have tested positive for H. pylori, urea breath testing or stool antigen testing to measure the success of eradication of H. pylori infection, with testing performed at least four weeks post-treatment, is considered MEDICALLY NECESSARY. […] For individuals with a refractory H. pylori infection, susceptibility testing (culture or nucleic acid based) is considered MEDICALLY NECESSARY. […] Urea breath testing or stool antigen testing to diagnose an H. pylori infection is considered NOT MEDICALLY NECESSARY for any of the following situations: For asymptomatic individuals of all ages. For individuals 18 years and older with typical symptoms of gastroesophageal reflux disease (i.e., heartburn, regurgitation) who do not have a history of peptic ulcer disease (PUD). […] For individuals of all ages, serologic testing for H. pylori infection is considered NOT MEDICALLY NECESSARY.

• #77 Testing for Diagnosis of Helicobacter Pylori

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed.

• #78 Testing for Diagnosis of Helicobacter Pylori

  https://www.southcarolinablues.com/web/public/brands/medicalpolicy/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed.

• #79 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed (Lamont, 2022). […] Dechant et al. (2020) evaluated the accuracy of various rapid urease tests (RUTs) and compared it with histopathology results. No differences were detected in the sensitivity or specificity of the various RUTs and RUTs had comparable results to histology; however, in patients treated with proton pump inhibitors and antibiotics. RUTs seemed to be more sensitive compared to histology. Pohl et al. (2019) discuss the drawbacks of RUTs, including false negative test results if the bacterial load is less than 104 in the gastric biopsy and false positive test results with some urease positive bacteria, affecting the sensitivity and specificity of RUTs. Commercially available RUTs, such as HpFast, CLOTest, and HpOne, have reported specificities ranging from 95% to 100%, but their sensitivity is moderate (85% to 95%) (Pohl et al., 2019).

• #80 Helicobacter pylori

  https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/conditions-and-treatments/gastro/helicobacter-pylori/

  All patients with symptoms related to the upper gastrointestinal tract should be tested for H. pylori. […] Non-invasive testing is recommended in situations where there is a low risk of the patient having gastric cancer, such as those up to 45 years and without alarm symptoms (such as weight loss, dysphagia, overt gastrointestinal bleeding, abdominal mass or iron-deficient anaemia). […] Non-invasive tests include: Urea breath test (UBT): recommended non-invasive test of choice, where available […] Faecal antigen testing: less sensitive than UBT but with high specificity. Can be performed if UBT not available. […] H. pylori serology: less sensitive and specific. Perform only if UBT or faecal antigen testing is unavailable. […] For patients over 45 years or with alarm symptoms, endoscopy is recommended.

• #81 Helicobacter pylori – Wikipedia

  https://en.wikipedia.org/wiki/Helicobacter_pylori

  Proton-pump inhibitors and antibiotics should be discontinued for at least 30 days prior to testing for H. pylori infection or eradication, as both agents inhibit H. pylori growth and may lead to false negative results. Testing to confirm eradication is recommended 30 days or more after completion of treatment for H. pylori infection. H. pylori breath testing or stool antigen testing are both reasonable tests to confirm eradication. H. pylori serologic testing, including IgG antibodies, are not recommended as a test of eradication as they may remain elevated for years after successful treatment of infection. […] An endoscopic biopsy is an invasive means to test for H. pylori infection. Low-level infections can be missed by biopsy, so multiple samples are recommended. The most accurate method for detecting H. pylori infection is with a histological examination from two sites after endoscopic biopsy, combined with either a rapid urease test or microbial culture. Generally, repeating endoscopy is not recommended to confirm H. pylori eradication, unless there are specific indications to repeat the procedure.

• #82 H. Pylori Test | Quick & Convenient Breath Test | Quest®

  https://www.questhealth.com/product/h.-pylori-breath-test-14839M.html?srsltid=AfmBOoq0rZp3ct93Wy_VCr6S9GZEaPC6v-zmIqG5oDWWmIP1rHa76BJJ

  Detects the presence of the Helicobacter pylori (H. pylori) bacteria which may cause digestive disorders and stomach-related medical conditions. […] This urea breath test is used to detect the presence of H. pylori, which causes infection, and to monitor treatment. […] H. pylori is a type of bacteria that can infect the stomach and intestines, causing inflammation and ulcers. […] H. pylori may cause digestive disorders and stomach-related medical conditions, such as infections, ulcers, inflammation, and stomach cancer. Persistent or recurring digestive issues or abdominal pain may indicate an H. pylori infection. […] If you are experiencing persistent or recurring digestive issues, contact your physician. […] Some medications could affect test accuracy: Proton pump inhibitors (PPIs) such as Prilosec, Prevacid, Nexium, Protonix, etc.

• #83 H. Pylori Test | Quick & Convenient Breath Test | Quest®

  https://www.questhealth.com/product/h.-pylori-breath-test-14839M.html?srsltid=AfmBOoq0rZp3ct93Wy_VCr6S9GZEaPC6v-zmIqG5oDWWmIP1rHa76BJJ

  Antibiotics including treatment for H. pylori. […] This test may NOT be right for you if you experience the following symptom. Seeing a specialist is recommended for more appropriate evaluation: Unexplained weight loss, Trouble swallowing, Have low blood count, called anemia, Have been told you are iron deficient without a cause, Have frequent nausea or persistent vomiting, Have yellowing of the skin, called jaundice, Have persistent or recurrent pain in the stomach area. […] If you are on one of these medications at this time or have been within the last 3 weeks, this test isn’t right for you. […] Long-term infection with H. pylori can increase the risk of other intestinal diseases, including stomach cancer.

• #84 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions. […] Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. […] Antrum is a preferential biopsy site for detecting H. pylori infection in most circumstances, but corpus biopsy from greater curve is suggested for patients with antral atrophy or intestinal metaplasia to avoid false negative results. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori.

• #85 What Is New in Helicobacter pylori Diagnosis. An Overview

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8152493/

  The examination of gastric mucosal biopsy specimens remains the gold standard for the detection of H. pylori, with a sensitivity of 95% and a specificity of 98%. In addition, it enables the visualization of gastric morphology at any time. However, in order to obtain an accurate diagnosis, two antral biopsies, one from the gastric angulus, and two biopsies from the corpus, are necessary. […] Upper endoscopy also allows to collect biopsy specimens for urease testing. The method takes advantage from the presence of pre-formed urease by the organism and, in media containing urea, the enzyme releases ammonia, increasing the pH and resulting in a color change of the medium. The urease test is rapid (RUT), easy to perform, highly specific, and inexpensive for H. pylori diagnosis. However, RUT requires a high density of bacteria, for example, in the standard commercial kits, at least a 104 bacterial load in the gastric specimens is required.

• #86 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is an indirect test of the presence of H. pylori based on the presence of urease in or on the gastric mucosa. It has an advantage over serology in that it only detects the presence of an active infection. […] The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%. […] The two most common reasons for false negative results are the recent use of proton pump inhibitors and the presence of intestinal metaplasia. […] It has also been recommended that RUT should not be used as the sole arbiter of the results of H. pylori eradication therapy because the sensitivity of the RUT is not 100% and thus a negative test does not fully exclude the presence of an active infection.

• #87 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is an indirect test of the presence of H. pylori based on the presence of urease in or on the gastric mucosa. It has an advantage over serology in that it only detects the presence of an active infection. […] The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%. […] The two most common reasons for false negative results are the recent use of proton pump inhibitors and the presence of intestinal metaplasia. […] It has also been recommended that RUT should not be used as the sole arbiter of the results of H. pylori eradication therapy because the sensitivity of the RUT is not 100% and thus a negative test does not fully exclude the presence of an active infection.

• #88 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is best considered as a screening test and not as the gold standard for H. pylori infection. […] False negative tests are more frequent than false positive tests and thus a negative result should not be used to exclude H. pylori when a wrong diagnosis would be detrimental to patient management. […] A positive culture is considered the only true gold standard for the diagnosis of H. pylori such that additional testing is needed when one suspects a false-negative result.

• #89 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Various diagnostic methods are developed to detect H. pylori infection and diagnostic tests with both high sensitivity and specificity, exceeding 90%, are necessary for accurate diagnosis of H. pylori infection in clinical practice. Although many diagnostic tests are available now, each method has its own advantages, disadvantages, and limitations. The choice of one method or another could be depended on availability and accessibility of diagnostic tests, level of laboratories, clinical conditions of patients, and likelihood ratio of positive and negative tests on different clinical circumstances. Diagnostic tests are usually divided into invasive (endoscopic-based) and noninvasive methods. Invasive diagnostic tests include endoscopic image, histology, rapid urease test, culture, and molecular methods. Non-invasive diagnostic tests included urea breath test, stool antigen test, serological, and molecular examinations. In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions.

• #90 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221

  More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes. […] Various diagnostic methods are developed to detect H. pylori infection and diagnostic tests with both high sensitivity and specificity, exceeding 90%, are necessary for accurate diagnosis of H. pylori infection in clinical practice. […] The choice of one method or another could be depended on availability and accessibility of diagnostic tests, level of laboratories, clinical conditions of patients, and likelihood ratio of positive and negative tests on different clinical circumstances.

• #91 Noninvasive Diagnostic Tests for Helicobacter pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p16.html

  Which noninvasive diagnostic test urea breath test, serology, or stool antigen test provides the most accurate diagnosis of Helicobacter pylori infection in symptomatic and asymptomatic patients? […] When compared with serology or stool antigen tests, the urea breath test has the highest diagnostic accuracy to identify H. pylori infection in patients without a history of gastrectomy or recent use of antibiotics or proton pump inhibitors. […] The urea breath test had the highest diagnostic accuracy and lowest false-negative rate for the detection of H. pylori. […] The American College of Gastroenterology (ACG) recommends testing in patients with active peptic ulcer disease, dyspepsia symptoms, and gastric mucosa-associated lymphoid tissue lymphoma, whereas the Maastricht guidelines also include patients starting long-term nonsteroidal anti-inflammatory drugs, those with idiopathic thrombocytopenic purpura, and those who desire testing.

• #92 Current Helicobacter pylori Diagnostics

  https://www.mdpi.com/2075-4418/11/8/1458

  The high prevalence of Helicobacter pylori and the variety of gastroduodenal diseases caused by this pathogen necessitate the use of only accurate methods both for the primary diagnosis and for monitoring the eradication effectiveness. There is a broad spectrum of diagnostic methods available for detecting H. pylori. All methods can be classified as invasive or non-invasive. […] Non-invasive diagnostic tests such as the urea breathing test and stool antigen test are recommended for primary diagnosis of H. pylori infection. […] The urease breath test is a “gold standard” in the diagnosis of H. pylori infection. […] Modern non-invasive tests provide high reliability in H. pylori detection due to their high sensitivity and specificity. […] There are several diagnostic methods for detecting H. pylori infections. All methods can be broadly classified as invasive or non-invasive.

• #93 Noninvasive Diagnostic Tests for Helicobacter pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p16.html

  The ACG states that the urea breath test has the highest sensitivity and specificity overall but, in a low-prevalence population (around 20%), stool antigen testing also performs well. […] Family physicians should test all patients with dyspepsia for H. pylori, and although the urea breath test offers the lowest false-negative rates, the false-negative rates of the more readily available serology and stool antigen tests are only slightly higher.

• #94 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method. […] Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in the diagnosis of H. pylori infection.

• #95 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  The rapid in-office, monoclonal test is widely used and provides significant benefit in terms of availability and speed. However, a study using the test as a reference to compare against a new test found the in-office test to only have a 0.50 sensitivity and 0.96 specificity out of 162 patients (Korkmaz et al., 2015). […] The UBT has also been well-validated. A meta-analysis by Ferwana et al. (2015) including 3999 patients of 23 studies found the diagnostic test to have a pooled sensitivity of 0.96 and a pooled specificity of 0.93. The authors noted that their populations had significant heterogeneity but concluded that the UBT had high diagnostic accuracy for detecting an H. pylori infection (Ferwana et al., 2015). This test is often considered the gold standard for diagnosing an H. pylori infection (Patel et al., 2014).

• #96 Helicobacter pylori Diagnosis and Treatment Guidelines

  https://www.ajmc.com/view/helicobacter-pylori-diagnosis-and-treatment-guidelines

  Diagnostic testing methods available for H pylori include noninvasive and invasive techniques. Noninvasive techniques, which allow physicians to easily detect H pylori, include serology, urea breath testing, and stool antigen detection. Invasive techniques involve the use of endoscopy to gather gastric biopsies and include histology, culture, and rapid urease test. Serology testing is the least sensitive noninvasive technique. It has 75% to 85% sensitivity compared with greater than 95% for fecal antigen and urea breath testing. Because of this and the high rate of false positives, it is no longer recommended in the United States. Urea breath and fecal tests detect active infection, have high negative and positive predictive values, are excellent for pretreatment or posttreatment testing, and are highly specific.

• #97 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is an indirect test of the presence of H. pylori based on the presence of urease in or on the gastric mucosa. It has an advantage over serology in that it only detects the presence of an active infection. […] The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%. […] The two most common reasons for false negative results are the recent use of proton pump inhibitors and the presence of intestinal metaplasia. […] It has also been recommended that RUT should not be used as the sole arbiter of the results of H. pylori eradication therapy because the sensitivity of the RUT is not 100% and thus a negative test does not fully exclude the presence of an active infection.

• #98 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Some medications are known to inhibit the growth or urease activity of H. pylori and can cause a false negative H. pylori test result. Proton pump inhibitors, antibiotics, and bismuth-containing medications may decrease sensitivity of tests, thereby increasing rates of a false negative. Eradication testing is often done weeks after treatment is completed (Lamont, 2022). […] Dechant et al. (2020) evaluated the accuracy of various rapid urease tests (RUTs) and compared it with histopathology results. No differences were detected in the sensitivity or specificity of the various RUTs and RUTs had comparable results to histology; however, in patients treated with proton pump inhibitors and antibiotics. RUTs seemed to be more sensitive compared to histology. Pohl et al. (2019) discuss the drawbacks of RUTs, including false negative test results if the bacterial load is less than 104 in the gastric biopsy and false positive test results with some urease positive bacteria, affecting the sensitivity and specificity of RUTs. Commercially available RUTs, such as HpFast, CLOTest, and HpOne, have reported specificities ranging from 95% to 100%, but their sensitivity is moderate (85% to 95%) (Pohl et al., 2019).

• #99 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  ELISA-based serological tests are also available for detection of H. pylori. However, serological tests often need validation at the local level, which may not be practical in routine practice. Furthermore, serological tests do not distinguish between past and present infections. Serological tests also have a very low positive predictive value in populations with low or average prevalence, as the antibodies will be detected even after an infection has been treated or naturally resolved. In these low-prevalence areas, a positive serological test is more likely to be a false positive (Lamont, 2022). […] Other tests such as PCR-based tests are infrequently used. The PCR test, despite its high accuracy, is often too expensive for routine use. In fact, nested PCR tests have approached 100% sensitivity and 100% specificity for detection of H. pylori (Singh et al., 2008), but the test may not be widely available and may be of limited use due to high cost (Lamont, 2022; Patel et al., 2014). PCR tests have been used for diagnostic purposes as well as identifying genetic variants of the bacteria and pathogenic genes present in a patient. A variety of body fluids, such as stool and saliva, have been used in PCR tests for this bacterial species (Patel et al., 2014).

• #100 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  There are four tests for H. pylori. They check your breath, stool (poop), blood or stomach/small intestine lining for signs of the bacteria. […] An H. pylori breath test is the most common test for H. pylori. It measures the amount of carbon dioxide in your breath after you drink a special solution containing urea. H. pylori bacteria break down urea into carbon dioxide. Excess carbon dioxide in your breath is a sign of an H. pylori infection. […] An H. pylori stool antigen test (SAT) detects antigens associated with H. pylori in your poop. An antigen is a protein thats unique to a specific type of cell, virus or bacteria. Theyre markers that allow your immune system (your bodys infection-fighting system) to identify germs. Having H. pylori antigens in your poop means you have the bacteria in your gut.

• #101 Testing for H. pylori: Which Patients, Which Test, How to Treat? – Fitzgerald Health Education Associates

  https://www.fhea.com/resource-center/testing-for-h-pylori-which-patients-which-test-how-to-treat/

  The UBT involves drinking urea that is labeled with the nonradioactive isotope carbon-13. If H. pylori is present, its urease will split the carbon-13-labeled urea to produce ammonia and carbon-13-labeled carbon dioxide, which is expired in the breath and measured in a postingestion breath sample. […] UBT offers the advantages of measuring active infection and having a sensitivity and specificity of 95%. […] The FAT identifies H. pylori antigen in a stool sample by enzyme immunoassay with the use of polyclonal or monoclonal antibodies. As with the UBT, a positive result provides definitive evidence of active infection. […] Clinicians should test for H. pylori only when they intend to offer treatment for positive results. According to ACG guidelines, the following are established indications for diagnosis and treatment of H. pylori infection: Active peptic ulcer disease (gastric or duodenal ulcer) or confirmed history of peptic ulcer disease (not previously treated for H. pylori infection), Gastric mucosa-associated lymphoid tissue (MALT) lymphoma (low-grade), After endoscopic resection of early gastric cancer, Uninvestigated dyspepsia (depending upon H. pylori prevalence).

• #102 Helicobacter Pylori (H. Pylori) Tests: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/helicobacter-pylori-h-pylori-tests/

  There are different ways to test for an H. pylori infection. The most common tests use samples of your breath or stool. In certain cases, tests are done on a sample of tissue that’s removed from inside your stomach. […] H. pylori tests are used to: Find out if an H. pylori infection is the cause of digestive symptoms; Find out if treatment has cured an H. pylori infection. […] You may need an H. pylori test if you have symptoms of gastritis or an ulcer. These conditions are often caused by H. pylori bacteria. […] If you’ve been treated for an H. pylori infection, you may need testing to see if treatment worked to get rid of all the bacteria. If H. pylori remains in your body, it can grow and cause symptoms again. […] A negative (normal) H. pylori test result means that you probably don’t have an H. pylori infection. A positive test result means that you have an H. pylori infection. Your provider will usually prescribe one or more antibiotics to treat the infection. You will usually take other medicines to relieve your symptoms and help heal your stomach. After you finish your treatment, your provider may order repeat tests to make sure all the H. pylori bacteria is gone.

• #103 H. PYLORI Stool Antigen Testing – TECHLAB, Inc.

  https://www.techlab.com/blog/techlab-publications/h-pylori/h-pylori-stool-antigen-testing/

  Stool antigen testing is a widely accepted non-invasive and simple option for patient and physician, making it a good frontline tool for diagnosis. The test is specifically designed to identify current infection by detecting antigen(s) that are produced by live H. pylori bacteria and shed into the stool. […] The 2017 ACG Clinical Guideline strongly emphasize a Test-Treat-Test approach. This approach is critical because if treatment does not work, the patient will continue to be infected with H. pylori and continue to be at-risk for H. pylori-related disease such as peptic ulcer disease and gastric cancer. […] H. pylori testing should be performed for all patients with active peptic ulcer disease, mucosa-associated lymphoma or early gastric cancer. […] Due to high rates of antibiotic resistance, patients should be re-tested after treatment to confirm eradication with a method that identifies active disease. […] Testing methods which detect active disease, such as stool antigen testing, are preferred.

• #104 H. pylori (Helicobacter pylori ) Tests: How It’s Done, Results

  https://my.clevelandclinic.org/health/diagnostics/5217-h-pylori-tests

  An H. pylori blood test detects antibodies associated with an H. pylori infection. Antibodies are proteins your immune system makes if it detects a harmful antigen. The antibodies circulate in your bloodstream to find and destroy the offending germ (like H. pylori). […] A downside of blood tests, compared to the others, is that they cant distinguish between active infections and a past infection thats already cleared. Antibodies can still circulate in your bloodstream after an infection is gone. […] For this reason, providers mostly use blood tests to screen for H. pylori infections in populations where the bacteria are more common. H. pylori is more widespread in Africa, South America and western Asia. […] An upper endoscopy is the most accurate at detecting H. pylori. But unlike the other tests, an endoscopy is invasive. Your provider may perform this test if theyre looking for other issues (like signs of cancer) in addition to H. pylori infection. This test involves using a scope to remove tissue from your stomach or duodenum and testing the sample for H. pylori.

• #105 Helicobacter pylori Infection: Options for Testing and Treatment – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/september-2012/helicobacter-pylori-infection-options-for-testing-and-treatment/

  Finally, endoscopic tests for H. pylori infection—including urease-based tests, histologic assessment, and culture—all rely on biopsy of the gastric mucosa. […] Diagnosis of Helicobacter pylori Infection […] As reviewed by McColl, several tests are available that can aid in the diagnosis of H. pylori infection. Nonendoscopic tests include serology tests, urea breath testing, and fecal antigen tests; endoscopic tests include urease-based tests, histologic assessment, and culture of biopsy samples. […] A final point to remember is that serologic testing is not a reliable means of proving H. pylori eradication. […] When to Treat Patients for Helicobacter pylori Infection […] When deciding which patients to test and treat for H. pylori infection, clinicians need to have a clear idea as to why they are testing a particular patient and whether they are committed to treatment. […] Further Research […] While guidelines, including the recently published Maastricht IV Consensus Report, are available to aid in the management of patients with H. pylori infection, further research is needed in several areas.

• #106 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221.htm

  In the present article, we briefly review the current options and developments of diagnosis tests and associated applications in clinical practices, as well as choice of diagnostic tests on different clinical conditions. […] Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. […] Antrum is a preferential biopsy site for detecting H. pylori infection in most circumstances, but corpus biopsy from greater curve is suggested for patients with antral atrophy or intestinal metaplasia to avoid false negative results. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori.

• #107 Diagnosis of Helicobacter pylori using the rapid urease test

  https://atm.amegroups.org/article/view/5299/html

  The RUT is an indirect test of the presence of H. pylori based on the presence of urease in or on the gastric mucosa. It has an advantage over serology in that it only detects the presence of an active infection. […] The sensitivity of various RUT tests as primary diagnostic tests is high and has been reported to vary between approximately 80% and 100% and specificity between 97% and 99%. […] The two most common reasons for false negative results are the recent use of proton pump inhibitors and the presence of intestinal metaplasia. […] It has also been recommended that RUT should not be used as the sole arbiter of the results of H. pylori eradication therapy because the sensitivity of the RUT is not 100% and thus a negative test does not fully exclude the presence of an active infection.

• #108 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Conventional endoscopic exam is usually performed to diagnose H. pylori-associated diseases, such as peptic ulcer diseases, atrophic gastritis, MALT lymphoma and gastric cancer. Endoscopy is also an instrument routinely used to obtain specimens, usually gastric mucosa from biopsy, for further studies on other invasive tests, including rapid urease test, histology, culture, and molecular methods. […] Histology is usually considered to be the gold standard in the direct detection of H. pylori infection and is also the first method used for the detection of H. pylori. […] For routine clinical practice, rapid urease test (RUT) is the most useful invasive test for the diagnosis of H. pylori infection because it is inexpensive, rapid, easy to perform, highly specific and widely available. […] Culturing of H. pylori from gastric biopsy specimen is a highly specific but less sensitive method.

• #109 Helicobacter pylori Bacterial Infection – Creative Diagnostics

  https://www.creative-diagnostics.com/helicobacter-pylori-bacterial-infection.htm

  Serologic antibody tests are simple and inexpensive, but they cannot distinguish whether the result is a previous or ongoing infection, so they are often used in epidemiologic investigations of infection in populations. […] In recent years polymerase chain reaction (PCR)-based methods, such as multiplex PCR and real-time fluorescent quantitative PCR, have also been widely used for Hp detection. Molecular detection of formalin-embedded biopsy samples or RUT samples using PCR methods, of which quantitative PCR is the most appropriate, and fluorescence in situ hybridization have been shown to be highly accurate in detecting Hp, and can also be used in conjunction with molecular resistance testing.

• #110 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  The AGA released guidelines on gastrointestinal evaluation of iron deficiency anemia. AGA recommends that patients with iron deficiency anemia, without other identifiable etiology after bidirectional endoscopy, should undergo noninvasive testing for H. pylori over no testing at all to reduce the incidence of gastric cancer (Ko et al., 2020). […] American College of Gastroenterology/Canadian Association of Gastroenterology The ACG and CAG have released guidelines on testing for H. pylori: […] All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Those who test positive should be offered treatment for the infection.

• #111 Helicobacter pylori Diagnosis and Treatment Guidelines

  https://www.ajmc.com/view/helicobacter-pylori-diagnosis-and-treatment-guidelines

  It is critical to establish which patients should be tested for H pylori because all patients with a positive test of active infection should be offered treatment. The 2017 American College of Gastroenterology (ACG) Clinical Guideline recommends that patients with active peptic ulcer disease (PUD), a history of PUD (unless previous cure of H pylori infection has been documented), low-grade MALT lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) be tested for H pylori infection. A test that identifies active infection should be used for patients with a new diagnosis or a history of PUD. Such tests include urea breath tests, fecal antigen tests, or, if endoscopy is performed, mucosal biopsy-based tests. The guideline recommends that patients with a history of PUD who have been treated for H pylori undergo eradication testing with a urea breath test or fecal antigen test.

• #112 Noninvasive Diagnostic Tests for Helicobacter pylori Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/0701/p16.html

  The ACG states that the urea breath test has the highest sensitivity and specificity overall but, in a low-prevalence population (around 20%), stool antigen testing also performs well. […] Family physicians should test all patients with dyspepsia for H. pylori, and although the urea breath test offers the lowest false-negative rates, the false-negative rates of the more readily available serology and stool antigen tests are only slightly higher.

• #113 Helicobacter pylori Diagnosis and Treatment Guidelines

  https://www.ajmc.com/view/helicobacter-pylori-diagnosis-and-treatment-guidelines

  It is critical to establish which patients should be tested for H pylori because all patients with a positive test of active infection should be offered treatment. The 2017 American College of Gastroenterology (ACG) Clinical Guideline recommends that patients with active peptic ulcer disease (PUD), a history of PUD (unless previous cure of H pylori infection has been documented), low-grade MALT lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) be tested for H pylori infection. A test that identifies active infection should be used for patients with a new diagnosis or a history of PUD. Such tests include urea breath tests, fecal antigen tests, or, if endoscopy is performed, mucosal biopsy-based tests. The guideline recommends that patients with a history of PUD who have been treated for H pylori undergo eradication testing with a urea breath test or fecal antigen test.

• #114 Helicobacter Pylori Infection Testing – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/100_199/0177.html

  The American College of Gastroenterology no longer recommends serology for detection of H. pylori infection. […] Guidelines from the American College of Gastroenterology indicate post-treatment testing in all patients treated for H. pylori infection (ACG, 2007). […] Stool antigen testing and urea breath test are the recommended modalities for confirming eradication of H. pylori after treatment. […] According to ACG guidelines, all persons suspected of having peptic ulcer disease should be tested for H. pylori regardless of whether they are on non-steroidal anti-inflammatory drugs (NSAIDS). […] According to guidelines from the American Society for Gastrointestinal Endoscopy (ASGE, 2008), 30-40% of patients undergoing bariatric surgery are infected with H. pylori. […] Updated guidelines from the American College of Gastroenterology (Chey et al, 2017) add the following conditions to the list of indications for H. pylori testing:

• #115 Testing for H. pylori: Which Patients, Which Test, How to Treat? – Fitzgerald Health Education Associates

  https://www.fhea.com/resource-center/testing-for-h-pylori-which-patients-which-test-how-to-treat/

  The ACG’s most recent H. pylori treatment guideline extends the list of potential indications for testing to include patients initiating long-term nonsteroidal anti-inflammatory drug therapy, those starting prophylactic low-dose aspirin, those with unexplained iron deficiency anemia despite an appropriate evaluation, and adults with idiopathic thrombocytopenic purpura. […] The test-and-treat strategy (noninvasive testing with UBT or FAT followed by treatment with a recommended oral regimen for those with a positive result) is recommended for patients with uninvestigated dyspepsia who are younger than 60 years and who do not have ALARMS findings. […] Patients who test positive for H. pylori infection are offered eradication therapy, which typically includes two antibiotics plus a PPI and/or a bismuth preparation.

• #116 Helicobacter pylori Diagnosis and Treatment Guidelines

  https://www.ajmc.com/view/helicobacter-pylori-diagnosis-and-treatment-guidelines

  The ACG Clinical Guideline recommends that patients be tested after treatment to ensure eradication of the infection. Testing should be performed using a urea breath test, fecal antigen test, or biopsy-based test at least 4 weeks after antibiotic therapy has completed and after PPI therapy has not been given for 1 to 2 weeks.

• #117 Helicobacter Pylori Infection Testing – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/100_199/0177.html

  The American College of Gastroenterology no longer recommends serology for detection of H. pylori infection. […] Guidelines from the American College of Gastroenterology indicate post-treatment testing in all patients treated for H. pylori infection (ACG, 2007). […] Stool antigen testing and urea breath test are the recommended modalities for confirming eradication of H. pylori after treatment. […] According to ACG guidelines, all persons suspected of having peptic ulcer disease should be tested for H. pylori regardless of whether they are on non-steroidal anti-inflammatory drugs (NSAIDS). […] According to guidelines from the American Society for Gastrointestinal Endoscopy (ASGE, 2008), 30-40% of patients undergoing bariatric surgery are infected with H. pylori. […] Updated guidelines from the American College of Gastroenterology (Chey et al, 2017) add the following conditions to the list of indications for H. pylori testing:

• #118 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  American Gastroenterological Association (AGA) The AGA recommends that patients 55 years or younger without alarm features should receive H. pylori test and treat followed by acid suppression if symptoms remain and note that H. pylori testing is optimally performed by a 13C-urea breath test or stool antigen test. Alarm features include symptoms such as recurrent vomiting and weight loss. Additionally, the AGA indicates that although the yield of endoscopy is low, it is recommended for patients older than 55 years of age and for younger patients presenting with new-onset dyspepsia. They reason that endoscopy with biopsy is the preferred test for this age group because upper gastrointestinal malignancy becomes more common after age 55 years (Talley, 2005). […] In 2015 the AGA published a technical review on Upper Gastrointestinal biopsy to evaluate dyspepsia in the absence of visible mucosal lesions and found that:

• #119 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  American Gastroenterological Association (AGA) The AGA recommends that patients 55 years or younger without alarm features should receive H. pylori test and treat followed by acid suppression if symptoms remain and note that H. pylori testing is optimally performed by a 13C-urea breath test or stool antigen test. Alarm features include symptoms such as recurrent vomiting and weight loss. Additionally, the AGA indicates that although the yield of endoscopy is low, it is recommended for patients older than 55 years of age and for younger patients presenting with new-onset dyspepsia. They reason that endoscopy with biopsy is the preferred test for this age group because upper gastrointestinal malignancy becomes more common after age 55 years (Talley, 2005). […] In 2015 the AGA published a technical review on Upper Gastrointestinal biopsy to evaluate dyspepsia in the absence of visible mucosal lesions and found that:

• #120 Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management Helicobacter pylori Infection: Laboratory Support of Diagnosis

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_Hpylori/helicobacter-pylori-infection-laboratory-support-of-diagnosis-and-management

  For all types of H pylori tests, positive results indicate H pylori infection. Guidelines indicate that all patients with positive results be offered H pylori eradication therapy. Therefore, diagnostic testing for H pylori should only be performed if the clinician plans to offer treatment to patients who receive positive results. […] Treatment success should be assessed by follow-up testing with a nonendoscopic test, such as UBT or a stool antigen test, or a biopsy-based test if an endoscopy is indicated. Testing should be performed at least 4 weeks after completing eradication therapy. This approach allows any remaining H pylori to recover and repopulate the stomach in sufficient numbers to be detected reliably. Detection of H pylori following eradication therapy indicates recurrence or ineffective treatment.

• #121 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  For diagnosis without endoscopic biopsy specimens, the guidelines recommend 13C-urea breath test and stool antigen tests. To increase the diagnosis accuracy, the guidelines recommend more than two tests (two noninvasive tests or a biopsy-based and a noninvasive test) be completed. The guidelines recommend urea breath test or stool antigen test four or more weeks after treatment to confirm eradication of H. pylori and recommend against using endoscopic biopsy methods and single serological tests to confirm eradication. The guidelines also recommend against anti-H. pylori antibody tests as a single test to diagnose H. pylori in a clinical setting (Kato et al., 2020). […] Maastricht V/Florence Consensus Report This report was published in 2017 on behalf of the European Helicobacter and Microbiota Study Group and Consensus panel. The panel reports that UBT is the most investigated and best recommended non-invasive test in the context of a test-and-treat strategy. The panel also notes that monoclonal tests can be used and that serological tests can be used only after validation. However, rapid office serology tests are not recommended and should be avoided. The guidelines recommend the rapid urease test (RUT) as a first line diagnostic test if there is an indication for endoscopy and no contraindication for biopsy. The guideline state that H. pylori is linked to unexplained iron deficiency anaemia (IDA), idiopathic thrombocytopenic purpura, and vitamin B12 deficiency, and in these disorders, an H. pylori infection should be sought and eradicated. The guidelines state that PPIs should be stopped two weeks and antibiotics and other bismuth compounds should be stopped 4 weeks before testing for H. pylori. In cases of chronic (active) gastritis in which H. pylori is not detected by histochemistry, immunohistochemical testing of H. pylori can be used as an ancillary test. If histology is normal, no immunohistochemical staining should be performed. It is recommended to perform clarithromycin susceptibility testing when a standard clarithromycin-based treatment is considered as the first-line therapy, except in populations or regions with well documented low clarithromycin resistance (15%). Pepsinogen (Pg) serology is considered the most useful non-invasive test to explore gastric mucosa status (non-atrophic vs atrophic). The PgI/PgII ratio can never be assumed as a biomarker of gastric neoplasia. UBT is the best option for confirmation of H. pylori eradication and monoclonal SAT is an alternative. It should be performed at least four weeks after completion of therapy (Malfertheiner et al., 2017).

• #122 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  For diagnosis without endoscopic biopsy specimens, the guidelines recommend 13C-urea breath test and stool antigen tests. To increase the diagnosis accuracy, the guidelines recommend more than two tests (two noninvasive tests or a biopsy-based and a noninvasive test) be completed. The guidelines recommend urea breath test or stool antigen test four or more weeks after treatment to confirm eradication of H. pylori and recommend against using endoscopic biopsy methods and single serological tests to confirm eradication. The guidelines also recommend against anti-H. pylori antibody tests as a single test to diagnose H. pylori in a clinical setting (Kato et al., 2020). […] Maastricht V/Florence Consensus Report This report was published in 2017 on behalf of the European Helicobacter and Microbiota Study Group and Consensus panel. The panel reports that UBT is the most investigated and best recommended non-invasive test in the context of a test-and-treat strategy. The panel also notes that monoclonal tests can be used and that serological tests can be used only after validation. However, rapid office serology tests are not recommended and should be avoided. The guidelines recommend the rapid urease test (RUT) as a first line diagnostic test if there is an indication for endoscopy and no contraindication for biopsy. The guideline state that H. pylori is linked to unexplained iron deficiency anaemia (IDA), idiopathic thrombocytopenic purpura, and vitamin B12 deficiency, and in these disorders, an H. pylori infection should be sought and eradicated. The guidelines state that PPIs should be stopped two weeks and antibiotics and other bismuth compounds should be stopped 4 weeks before testing for H. pylori. In cases of chronic (active) gastritis in which H. pylori is not detected by histochemistry, immunohistochemical testing of H. pylori can be used as an ancillary test. If histology is normal, no immunohistochemical staining should be performed. It is recommended to perform clarithromycin susceptibility testing when a standard clarithromycin-based treatment is considered as the first-line therapy, except in populations or regions with well documented low clarithromycin resistance (15%). Pepsinogen (Pg) serology is considered the most useful non-invasive test to explore gastric mucosa status (non-atrophic vs atrophic). The PgI/PgII ratio can never be assumed as a biomarker of gastric neoplasia. UBT is the best option for confirmation of H. pylori eradication and monoclonal SAT is an alternative. It should be performed at least four weeks after completion of therapy (Malfertheiner et al., 2017).

• #123 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  For diagnosis without endoscopic biopsy specimens, the guidelines recommend 13C-urea breath test and stool antigen tests. To increase the diagnosis accuracy, the guidelines recommend more than two tests (two noninvasive tests or a biopsy-based and a noninvasive test) be completed. The guidelines recommend urea breath test or stool antigen test four or more weeks after treatment to confirm eradication of H. pylori and recommend against using endoscopic biopsy methods and single serological tests to confirm eradication. The guidelines also recommend against anti-H. pylori antibody tests as a single test to diagnose H. pylori in a clinical setting (Kato et al., 2020). […] Maastricht V/Florence Consensus Report This report was published in 2017 on behalf of the European Helicobacter and Microbiota Study Group and Consensus panel. The panel reports that UBT is the most investigated and best recommended non-invasive test in the context of a test-and-treat strategy. The panel also notes that monoclonal tests can be used and that serological tests can be used only after validation. However, rapid office serology tests are not recommended and should be avoided. The guidelines recommend the rapid urease test (RUT) as a first line diagnostic test if there is an indication for endoscopy and no contraindication for biopsy. The guideline state that H. pylori is linked to unexplained iron deficiency anaemia (IDA), idiopathic thrombocytopenic purpura, and vitamin B12 deficiency, and in these disorders, an H. pylori infection should be sought and eradicated. The guidelines state that PPIs should be stopped two weeks and antibiotics and other bismuth compounds should be stopped 4 weeks before testing for H. pylori. In cases of chronic (active) gastritis in which H. pylori is not detected by histochemistry, immunohistochemical testing of H. pylori can be used as an ancillary test. If histology is normal, no immunohistochemical staining should be performed. It is recommended to perform clarithromycin susceptibility testing when a standard clarithromycin-based treatment is considered as the first-line therapy, except in populations or regions with well documented low clarithromycin resistance (15%). Pepsinogen (Pg) serology is considered the most useful non-invasive test to explore gastric mucosa status (non-atrophic vs atrophic). The PgI/PgII ratio can never be assumed as a biomarker of gastric neoplasia. UBT is the best option for confirmation of H. pylori eradication and monoclonal SAT is an alternative. It should be performed at least four weeks after completion of therapy (Malfertheiner et al., 2017).

• #124 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  The guidelines recommend biopsies for rapid urease test and other cultures should only be taken if treatment is likely to be offered in the case of a confirmed infection. Treatment may be considered if H. pylori is an incidental finding at endoscopy. […] The guidelines recommend against a test and treat strategy for H. pylori infection in children. The panelists explained that performing a noninvasive test to detect infection and treat is not needed because H. pylori infection usually does not cause any symptoms in the absence of peptic ulcer disease (PUD). […] The guidelines recommend that testing for H. pylori be performed in children with gastric or duodenal PUD. […] The guidelines recommend against diagnostic testing for H. pylori infection in children with functional abdominal pain, iron deficiency anemia, and when investigating causes of short stature. Serology-based testing was also not recommended.

• #125 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  The guidelines recommend biopsies for rapid urease test and other cultures should only be taken if treatment is likely to be offered in the case of a confirmed infection. Treatment may be considered if H. pylori is an incidental finding at endoscopy. […] The guidelines recommend against a test and treat strategy for H. pylori infection in children. The panelists explained that performing a noninvasive test to detect infection and treat is not needed because H. pylori infection usually does not cause any symptoms in the absence of peptic ulcer disease (PUD). […] The guidelines recommend that testing for H. pylori be performed in children with gastric or duodenal PUD. […] The guidelines recommend against diagnostic testing for H. pylori infection in children with functional abdominal pain, iron deficiency anemia, and when investigating causes of short stature. Serology-based testing was also not recommended.

• #126 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Proton pump inhibitors (PPIs) should be stopped two weeks before H. pylori testing, and antibiotics should be stopped four weeks before H. pylori testing. Diagnosis should be based on either: positive culture or H. pylori gastritis on histopathology with at least 1 other positive biopsy-based test. […] The non-invasive diagnostic testing was indicated in children when investigating causes of chronic immune thrombocytopenic purpura or for the assessment of anti-H. pylori therapy at least after four weeks of therapy (L. Jones et al., 2017). […] Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition (JSPGHAN) The JSPGHAN have updated their guidelines for H. pylori testing in pediatrics, including recommendations for diagnostic methods in children. […] For diagnosis using endoscopic biopsy specimens, the guidelines recommend considering the performance and accuracy of the rapid urease test, recommending an additional urea breath test or stool antigen test when there is inconsistency between histopathology and the rapid urease test. The guidelines further recommend histological examination of gastric biopsies, and culture diagnostic tests to diagnose active H. pylori infection (Kato et al., 2020).

• #127 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. […] Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies. Molecular methods have been used in variable specimens other than gastric mucosa. More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes.

• #128 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221

  Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy. […] The developments of current diagnostic methods allow to have a more accurate diagnosis of H. pylori infection, which in turn improving the management of H. pylori-associated diseases.

• #129 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4616200/

  Since the application of polymerase chain reaction (PCR) to detect H. pylori infection, PCR has been used extensively for the diagnosis of H. pylori from gastric biopsy specimens, saliva, stool, gastric juice and variable specimens. […] Urea breath test (UBT) has been used for almost 30 years and is still the most popular and accurate noninvasive test for diagnosis of H. pylori infection. […] Stool antigen test (SAT) is the other noninvasive method with good sensitivity and specificity, 94% and 97% respectively in global meta-analysis, in the diagnosis of H. pylori infection. […] Numerous serological tests based on the detection of anti-H. pylori IgG antibody are widely available for H. pylori diagnosis and EIA test is the most common and accurate technique among them. […] Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy.

• #130 Advances in Diagnostic Modalities for Helicobacter pylori Infection

  https://www.mdpi.com/2075-1729/14/9/1170

  Advances in Diagnostic Modalities for Helicobacter pylori Infection […] Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. […] Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. […] Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. […] Various diagnostic methods, both invasive and non-invasive, are available for detecting H. pylori infection. […] Non-invasive diagnostic methods have been developed and are now widely used. These non-invasive methods fall into three primary categories: serological assays, stool antigen tests, or urea breath tests. […] The H. pylori stool antigen (HpSA) test offers a distinct advantage over other commonly used diagnostic methods by detecting the presence of the bacterium itself rather than antibodies produced in response to it. […] According to various studies and the International Consensus Report, both the urea breath test (UBT) and stool antigen test are regarded as first-line diagnostic methods, with sensitivity and specificity exceeding 90%. […] The urea breath test (UBT) is another widely available diagnostic tool with high sensitivity and specificity, typically ranging from 90% to 100%. […] These diagnostic modalities include collecting mucosal specimens through endoscopic biopsy, histological examination, bacterial cultures, a rapid urease test, and PCR-based analyses. […] Advances in molecular biology have led to the development of highly accurate diagnostic tools for detecting H. pylori infection. […] The Campylobacter-like organism (CLO) test depends on the organism’s production of urease. […] Recognition of H. pylori as the leading player in several gastroduodenal diseases has contributed to the growing demand for its diagnosis. […] Recent advances in H. pylori detection have focused on improving non-invasive methods, enhancing molecular techniques, and utilizing novel technologies.

• #131 Advances in Helicobacter pylori Diagnosis and Management: Overcoming Resistance and Enhancing Treatment | Meridian Bioscience

  https://www.meridianbioscience.com/diagnostics-blog/unveiling-h-pylori-trends-updates-on-diagnosis-and-management/

  Serological Testing: While testing for H. pylori antibodies through blood or serum (such as H. pylori IgG detection) provides insights into exposure, its role in diagnosing active infection is limited due to the inability to distinguish between past and present infections. […] Molecular Testing: The use of H. pylori test kits that utilize polymerase chain reaction (PCR) for H. pylori DNA or RNA detection is on the rise. These tests offer the promise of detecting antibiotic resistance genes directly from stool samples or biopsy specimens, guiding more targeted therapy. […] The landscape of H. pylori diagnosis and management is evolving rapidly, driven by technological advancements and a deeper understanding of the bacteriums behavior and resistance mechanisms. The trend towards more precise diagnostics, tailored treatment regimens, and the exploration of non-antibiotic therapies reflects a comprehensive approach to tackling H. pylori infection.

• #132 Advances in Diagnostic Modalities for Helicobacter pylori Infection

  https://www.mdpi.com/2075-1729/14/9/1170

  Advances in Diagnostic Modalities for Helicobacter pylori Infection […] Helicobacter pylori (H. pylori) infection is a widespread global health issue with a varying prevalence influenced by geography, socioeconomic status, and demographics. […] Diagnostic methods for H. pylori have progressed significantly. Non-invasive techniques, such as serological assays, stool antigen tests, and urea breath tests, are practical and sensitive. Invasive methods, including endoscopic biopsy and molecular diagnostics, are more definitive but resource intensive. […] Recent advancements in diagnostic technology, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), biosensor technology, and next-generation sequencing (NGS), promise improved speed, accuracy, and accessibility. These innovations are expected to enhance the detection and management of H. pylori, potentially reducing the global disease burden. […] Various diagnostic methods, both invasive and non-invasive, are available for detecting H. pylori infection. […] Non-invasive diagnostic methods have been developed and are now widely used. These non-invasive methods fall into three primary categories: serological assays, stool antigen tests, or urea breath tests. […] The H. pylori stool antigen (HpSA) test offers a distinct advantage over other commonly used diagnostic methods by detecting the presence of the bacterium itself rather than antibodies produced in response to it. […] According to various studies and the International Consensus Report, both the urea breath test (UBT) and stool antigen test are regarded as first-line diagnostic methods, with sensitivity and specificity exceeding 90%. […] The urea breath test (UBT) is another widely available diagnostic tool with high sensitivity and specificity, typically ranging from 90% to 100%. […] These diagnostic modalities include collecting mucosal specimens through endoscopic biopsy, histological examination, bacterial cultures, a rapid urease test, and PCR-based analyses. […] Advances in molecular biology have led to the development of highly accurate diagnostic tools for detecting H. pylori infection. […] The Campylobacter-like organism (CLO) test depends on the organism’s production of urease. […] Recognition of H. pylori as the leading player in several gastroduodenal diseases has contributed to the growing demand for its diagnosis. […] Recent advances in H. pylori detection have focused on improving non-invasive methods, enhancing molecular techniques, and utilizing novel technologies.

• #133 Diagnosis of Helicobacter pylori infection: Progress and challenges | Enfermedades Infecciosas y Microbiología Clínica

  https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-diagnosis-helicobacter-pylori-infection-progress-S0213005X20302986

  These data raise the question about implantation of H. pylori screening programs for cancer gastric in developed countries. […] Miqueleiz-Zapatero et al. also reported interesting data on antimicrobial resistance to H. pylori at national level. […] Antibiotic resistance remains as the most critical factor on the effectiveness of therapies to eradicate H. pylori. […] Resistance of H. pylori can be detected either by phenotypic or genotypic techniques. […] At the moment, there are a number of molecular assays commercially available for H. pylori detection besides the most frequent clarithromycin resistance mutations. […] Therefore, it is urgent the development and availability of non-invasive tools, in particular stool-based molecular test, for antibiotic susceptibility to H. pylori.

• #134 Diagnosis of Helicobacter pylori infection: Progress and challenges | Enfermedades Infecciosas y Microbiología Clínica

  https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-diagnosis-helicobacter-pylori-infection-progress-S0213005X20302986

  These data raise the question about implantation of H. pylori screening programs for cancer gastric in developed countries. […] Miqueleiz-Zapatero et al. also reported interesting data on antimicrobial resistance to H. pylori at national level. […] Antibiotic resistance remains as the most critical factor on the effectiveness of therapies to eradicate H. pylori. […] Resistance of H. pylori can be detected either by phenotypic or genotypic techniques. […] At the moment, there are a number of molecular assays commercially available for H. pylori detection besides the most frequent clarithromycin resistance mutations. […] Therefore, it is urgent the development and availability of non-invasive tools, in particular stool-based molecular test, for antibiotic susceptibility to H. pylori.

• #135 Diagnosis and treatment patterns among patients with newly diagnosed Helicobacter pylori infection in the United States 2016–2019 | Scientific Reports

  https://www.nature.com/articles/s41598-023-28200-3

  Approximately 36% of the United States (US) population is infected with Helicobacter pylori (HP), a known major risk factor for peptic ulcer disease and gastric cancer. […] HP eradication reduces the rate of complications; however, the benefits are undermined by rising rates of HP eradication treatment failure. […] This study highlights gaps between guideline-recommended HP management and real-world patterns, underscoring the need to improve HP testing, treatment, and follow-up practices. […] Current US guidelines recommend eradication therapy for all people diagnosed with active HP infection. […] Clarithromycin-based triple therapy is no longer a preferred first-line treatment in the US due to steadily increasing resistance rates. […] Rising rates of HP eradication treatment failure undermine the potential benefits of HP eradication therapy and further contribute to increases in antibiotic resistance.

• #136 Testing for Diagnosis of Helicobacter Pylori

  https://www.myhealthtoolkit.com/web/public/brands/medicalpolicyhb/external-policies/testing-for-diagnosis-of-helicobacter-pylori/

  Yang et al. (2019) performed a meta-analysis investigating the association between H. pylori and colorectal cancer. Twenty-seven studies encompassing 14357 cases were included. The authors found an increased rate of colorectal cancer with H. pylori infection (odds ratio [OR] = 1.27). The authors also identified odds ratios for certain subgroups, such as Western countries (OR = 1.34), serological testing (OR = 1.20), multiple methods of testing (OR = 2.63), and cross-sectional studies (OR = 1.92) (Yang et al., 2019). […] Wang et al. (2019) performed a meta-analysis assessing the association between H. pylori and osteoporosis. Twenty-one studies totaling 9655 patients were analyzed. The authors found that H. pylori infection was associated with an increased risk of osteoporosis with an odds ratio of 1.39. However, the decrease of bone mineral density in H. pylori positive patients was not found to be significant compared to H. pylori negative patients (Wang et al., 2019).

• #137 Advances in Helicobacter pylori Diagnosis and Management: Overcoming Resistance and Enhancing Treatment | Meridian Bioscience

  https://www.meridianbioscience.com/diagnostics-blog/unveiling-h-pylori-trends-updates-on-diagnosis-and-management/

  Serological Testing: While testing for H. pylori antibodies through blood or serum (such as H. pylori IgG detection) provides insights into exposure, its role in diagnosing active infection is limited due to the inability to distinguish between past and present infections. […] Molecular Testing: The use of H. pylori test kits that utilize polymerase chain reaction (PCR) for H. pylori DNA or RNA detection is on the rise. These tests offer the promise of detecting antibiotic resistance genes directly from stool samples or biopsy specimens, guiding more targeted therapy. […] The landscape of H. pylori diagnosis and management is evolving rapidly, driven by technological advancements and a deeper understanding of the bacteriums behavior and resistance mechanisms. The trend towards more precise diagnostics, tailored treatment regimens, and the exploration of non-antibiotic therapies reflects a comprehensive approach to tackling H. pylori infection.

• #138 Diagnosis of Helicobacter pylori infection: Current options and developments

  https://www.wjgnet.com/1007-9327/full/v21/i40/11221

  Accurate determination of H. pylori status in patients after eradication therapy is important and UBT as well as SAT are recommended by guidelines to assess the efficacy of eradication therapy. […] The developments of current diagnostic methods allow to have a more accurate diagnosis of H. pylori infection, which in turn improving the management of H. pylori-associated diseases.

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