Helicobacter pylori: Overview and Considerations for Diagnostic Testing

"Test of Cure"

August 2010

Let’s briefly explore how one can best assess eradication of Helicobacter pylori infection after completion of a course of treatment.

As we have discussed, this can be confirmed by noninvasive means, either the urea breath test, or the fecal antigen test. Neither of these tests should be performed less than 4 weeks after completion of a treatment regimen. Due to persistence of antibody, a serological test is not recommended to assess cure.

If the urea breath test or fecal antigen test are still positive, or if the patient is still symptomatic after treatment, endoscopy is indicated so that pathology evaluation, and culture of biopsy samples for Helicobacter pylori can be performed.

Culture is necessary if antibiotic susceptibility testing is under consideration.

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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?