What are the ACG recommendations for testing for H pylori?

Updated: Apr 26, 2021
  • Author: BS Anand, MD; Chief Editor: Philip O Katz, MD, FACP, FACG  more...
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The 2017 American College of Gastroenterology (ACG) guidelines for the treatment of H pylori infection (HPI) include the following recommendations for testing for H pylori [33] :

  • All patients with active or past history of peptic ulcer disease (unless previous cure of HPI has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer

  • Patients with dyspepsia who are undergoing upper endoscopy (gastric biopsy specimens)

  • Patients on long-term, low-dose aspirin

  • Patients initiating long-term therapy with nonsteroidal anti-inflammatory agents (NSAIDs)

  • Patients with unexplained iron deficiency anemia following standard workup

  • Adults with idiopathic thrombocytopenic purpura

The 2017 ACG guidelines also recommend posttreatment testing to prove eradication of HPI with the use of a urea breath test, fecal antigen test, or biopsy-based testing at least 4 weeks following completion of antimicrobial therapy and after proton pump inhibitors have been withheld for 1-2 weeks. [33]

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