Helicobacter pylori: Overview and Considerations for Diagnostic Testing

Helicobacter spp. History¹

August 2010

The discovery of Helicobacter pylori’s association with peptic ulcer disease is a story in itself.

In 1984, a research group, led by Dr. Barry Marshall at Fremantle Hospital in Australia, proposed that what were then known as “pyloric Campylobacter” were indeed associated with peptic ulcer disease. The thought that a bacterium could survive the pH of the stomach and cause a specific disease entity was seen as a very controversial view at the time, and resulted in a great deal of criticism over the validity of Marshall’s work.

Dr. Marshall even went so far as to prove Koch’s postulates by drinking a suspension of Helicobacter pylori prepared in his laboratory. After 2 weeks, he developed dyspepsia and peptic ulcer disease. Helicobacter pylori was then isolated from endoscopic samples from his own stomach, thus completing Koch’s postulates.

Consequently, in 1994, the National Institutes of Health concluded that Helicobacter pylori was a causative factor in 90% of peptic ulcer disease and warranted treatment with antibiotics. Despite the earlier controversy, Dr. Marshall was ultimately vindicated; and received the 2005 Nobel Prize in Medicine.

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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?