II. Indications
- Dyspepsia evaluation
III. Labs: First-Line Helicobacter Pylori tests
-
Urea Breath Test
- Test Sensitivity: 97%
- Test Specificity: 100%
- Requires Fasting for 6 hours, no PPI for 2 weeks before test, and expensive
-
Stool monoclonal Antigen tests (enzyme immunoassay)
- Test Sensitivity: 92%
- Test Specificity: 94%
- Most accurate, but more expensive than immunochromatography
-
Stool monoclonal Antigen tests (Immunochromatography)
- Test Sensitivity: 69-87%
- Test Specificity: 87-93%
- Variable reliability, but available for office based testing
IV. Labs: Other Helicobacter PyloriAntibody or Antigen testing
- IgG testing may be positive for years after eradication
- Indicated only for initial diagnosis
- Not used to confirm H. pylori cure
- Reference lab Serology (ELISA for H. pylori IgG)
- Test Sensitivity: 90-93%
- Test Specificity: 95-96%
- Office-based lab whole blood Serology (ELISA for IgG)
- Test Sensitivity: 50-85%
- Test Specificity: 75-100%
- Urine ELISA for H. pylori IgG
- Test Sensitivity: 70-96%
- Test Specificity: 77-85%
-
Saliva
ELISA for H. pylori IgG
- Test Sensitivity: 82-91%
- Test Specificity: 71-85%
V. Other Testing: String Test
- Mechanism
- Polymer string is swallowed
- String is recovered and run for PCR or culture
- Accuracy
- Test Sensitivity: 75-80%
- Test Specificity: 75-100%
VI. Advantages
- Noninvasive procedure
VII. Disadvantages
- Tests do not confirm cure after H. pylori management
- Cure confirmation is only by the following tests
