Helicobacter pylori Invasive Testing

Aka: Helicobacter pylori Invasive Testing, H. pylori culture, Endoscopic Biopsy for H. pylori, Rapid Urease Test, CLO Test

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II. Indications

  1. Dyspepsia evaluation

III. Tests

  1. Gastric Biopsy with Steiner's Stain
    1. Test Sensitivity: 95%
    2. Test Specificity: 99-100%
  2. Rapid Urease Test (e.g. CLO Test)
    1. Test Sensitivity: 93-97%
    2. Test Specificity: >95%
  3. H. pylori culture
    1. Test Sensitivity: 70-80%
    2. Test Specificity: 100%

IV. Advantages

  1. Gold standard for H. pylori diagnosis
  2. Confirms cure for H. pylori

V. Disadvantages

  1. Requires endoscopic biopsy
  2. Sensitivity altered for histology and urease activity
    1. Proton Pump Inhibitors
    2. Antibiotics
    3. Bismuth

VI. References

  1. Meurer (2002) Am Fam Physician 65(7):1327-39 [PubMed]
  2. Snyder (1999) Can J Gastroenterol 13:585-9 [PubMed]

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