Helicobacter pylori infection diagnostic tests

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]

Endoscopic Diagnostic Tests

In patients who have not been on a PPI within 1-2 wk or an atibiotic or bismuth within 4 wk of endoscopy, the rapid urease test (RUT) provides an accurate, inexpensive means of identifying H.pylori.
For patients who have been taking a PPI, antibiotics, or bismuth, endoscopic testing for H.pylori should include biopsies from the gastric body and antrum for histology with or without rapid urease testing.
Though culture or polymerase chain reaction (PCR) are the primary means by which antibiotic sensitivites can be determined, neither is widely available for clinical use in the United States and therefore, cannot be routinely recommended.

Endoscopic diagnostic tests are biopsy-based diagnostic methods for H.pylori infection. These include:

• Histology
• Rapid urease testing
• Culture
• Polymerase chain reaction