Helicobacter pylori: Overview and Considerations for Diagnostic Testing

Endoscopy

August 2010

Endoscopy is recommended as a primary diagnostic method for:

• Any symptomatic patient 45 years or older
• Any patient with alarm features

A biopsy specimen obtained during endoscopy will be used for special staining and pathology interpretation. A Gram stain, acradine orange, Giemsa, silver stain, or immuno stains may be used for direct visualization of Helicobacter pylori bacteria.

Endoscopy has >95% sensitivity and specificity, with multiple biopsies resulting in even greater accuracy. The downside is that this is an invasive procedure, it is expensive, and specific expertise is required. Sensitivity of endoscopy can be affected by proton pump inhibitors, bismuth, or antibiotics, thus, this test cannot be used during treatment of the patient.

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Jump to section:

• Introduction
• Overview
• Helicobacter pylori
• Helicobacter spp. History¹
• Epidemiology²
• Pathogenesis
• Diagnosis of Infection
• Testing
• Types of Testing
• Endoscopy
• Rapid Urease Test
• Culture
• Types of Testing
• Urea Breath Test
• Urea Breath Test Limitations
• Serology - IgM and IgA ELISA³
• Serology: IgG ELFA
• Serology
• Serology Limitations
• Fecal Antigen Test EIA
• "Test of Cure"
• Algorithm
• Conclusions
• Tests Available From Mayo Medical Laboratories
• References
• Questions?