II. Indications
- Dyspepsia evaluation
III. Tests
- H. pylori culture
- Test Sensitivity: 70-80%
- Test Specificity: 100%
IV. Precautions
- Stop Antibiotics for 4 weeks before Helicobacter Pylori testing
- Stop Proton Pump Inhibitors (PPIs) for 2 weeks before Helicobacter Pylori testing
- Only Serology and Rapid Urease Test are not affected by Antibiotics and PPIs
V. Labs: Performed via Upper Endoscopy
- Histology (endoscopic biopsy) with Steiner's Stain
- Test Sensitivity: 70% (up to 95% in early studies)
- Test Specificity: 90% (up to 99% in early studies)
- Likelihood: LR+ 6.7, LR- 0.23
- Rapid Urease Test (e.g. CLO Test)
- Test Sensitivity: 67% (up to 93 to 97% in early studies)
- Test Specificity: 93%
- Likelihood: LR+ 9.6, LR- 0.31
-
Helicobacter Pylori Culture (endoscopic biopsy sample)
- Test Sensitivity: 45% (up to 70-80% in early studies)
- Test Specificity: 98%
- Likelihood: LR+ 19.6, LR- 0.31
- References
VII. Disadvantages
- Requires endoscopic biopsy
- Sensitivity altered for histology and urease activity
- Proton Pump Inhibitors
- Antibiotics
- Bismuth