What are the nonendoscopy-based tests used to identify H pylori in the workup of acute gastritis?

Updated: Jul 12, 2020
  • Author: Sarah El-Nakeep, MD; Chief Editor: BS Anand, MD  more...
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Nonendoscopy-based H pylori tests

H pylori stool antigen test (HpSA)

This test is based on the detection of the H pylori antigen in the stool. It has sensitivity and specificity above 90%. The HpSA can be used both for the diagnosis of H pylori and the confirmation of eradication after therapy.

Urea breath test

This study uses 13C- or 14C-labeled urea taken orally. H pylori metabolizes the urea and liberates the labeled carbon dioxide that is exhaled. This, in turn, can be quantified in breath samples. The sensitivity and specificity of the urea breath test is greater than 90%. This test is considered the noninvasive diagnostic method of choice in situations where endoscopy is not indicated. It can also be used to confirm eradication after therapy.

Serum antibodies test

The third nonendoscopy H pylori test depends on the presence of antibodies to H pylori in the serum. The major drawback to this test is that serologic assays may remain positive for as long as 3 years after eradication of the bacteria. Therefore, serologic assays are often unreliable to document eradication of H pylori. This test can be used for the diagnosis of H pylori, provided that the patient has not received any prior therapy for it.

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