How Is Helicobacter Pylori Infection Diagnosed?
It is protocol that testing for H. pylori is only performed if positive results will result in treatment. Those at risk for H. pylori and who have indications for testing are those with the following:
- Active peptic ulcer disease.
- Previous ulcer in which H. pylori eradication has not been proven.
- Early gastric cancer.
- Low grade gastric mucosa lymphoma.
Dyspepsia patients may be considered, as are patients on long-term NSAID or aspirin regimens, those who have iron deficiency or who suffer from immune thrombocytopenia.
- Non-invasive (without endoscopy) tests: Stool antigen test (detection of bacterial antigen) or urea breath test.
- Invasive (endoscopic) tests: Biopsy for urea release in tissues, histology of the tissue itself, and rarely, bacterial culture.
- Confirmation of eradication: All patients treated for H. pylori should be tested as a “proof of cure,” using the urea breath test, stool antigen test, or endoscopy-based testing if endoscopy is indicated for other reasons.