What is the role of endoscopy in the workup of acute gastritis?

Updated: Jun 13, 2019
  • Author: Mohammad Wehbi, MD; Chief Editor: BS Anand, MD  more...
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Answer

Three endoscopy-based H pylori tests are available, as follows:

  • The first test is the rapid urease test (RUT). It is performed by placing a gastric biopsy specimen, obtained at endoscopy, onto a gel- or membrane-containing urea and a pH-sensitive indicator. If H pylori is present, the bacterial urease hydrolyzes urea and changes the color of the media. The sensitivity and specificity of this test is greater than 90%.

  • Another test is bacterial culture of H pylori. It is highly specific but is not widely used because of the degree of expertise required. It is used when antibiotic susceptibilities are necessary.

  • Histologic detection of H pylori in the biopsy specimen is another endoscopy-based test. Appropriate staining is achieved using such stains as hematoxylin and eosin, Warthin-Starry, Giemsa, or Genta.

American Society for Gastrointestinal Endoscopy guidelines suggest endoscopic evaluation for patients older than 50 years who have alarm features such as weight loss and anemia. For patients younger than 50 years with no alarm features who are H pylori negative, endoscopic evaluation may be considered. [5]


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