Common Test-Ordering Errors
Part 7: Overordered Microbiology Tests

H pylori Diagnostic Algorithm

October 2010

The basics of the approach are as follows—for patients with  worrisome symptoms (that is, tarry stools, bloody vomit, anemia, weight loss, and/or difficulty swallowing) the preferred first test is endoscopy. This is recommended because it is the best way to most accurately assess patients and not miss serious disorders.  For adults who do not have those symptoms, the preferred test is the urea breath test or the fecal antigen test. For children who do not have those symptoms, because the urea breath test can  be difficult to administer to children, the preferred first test is the fecal antigen test . In both age groups, IgG serology testing is an optional alternate testing choice, but IgM and IgA are not recommended..

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H pylori Diagnostic Algorithm

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Jump to section:

• Introduction
• Testing at Mayo Medical Laboratories
• Common MML Test-Ordering Errors
• Common Microbiology Test-Ordering Problems
• Helicobacter pylori
• H pylori IgM (and IgA) Not Useful
• H pylori Diagnostic Algorithm
• H pylori Diagnostic Algorithm
• Ova and Parasite
• Parasitic Investigation of Stool Specimens Algorithm
• Initial Testing in Patients with Watery Diarrhea
• Conclusion
• Questions?