title: Helicobacter pylori infection - recent developments in diagnosis.
abstract: Considering the recommended indications for Helicobacter pylori (H. pylori) eradication therapy and the broad spectrum of available diagnostic methods, a reliable diagnosis is mandatory both before and after eradication therapy. Only highly accurate tests should be used in clinical practice, and the sensitivity and specificity of an adequate test should exceed 90%. The choice of tests should take into account clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy and the availability of the tests. This review concerns some of the most recent developments in diagnostic methods of H. pylori infection, namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H. pylori infection, such as magnifying endoscopy techniques and chromoendoscopy. In addition, the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups. Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test. Bacterial culture from the gastric biopsy is the gold standard technique, and is recommended for antibiotic susceptibility test. Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available, while molecular methods have gained attention mostly for detecting antibiotic resistance.
authors: Ana Isabel Lopes, Centro Académico de Medicina de Lisboa, Faculdade de Medicina da Universidade de Lisboa, 749-016 Lisboa, Portugal.
authors: Ana Isabel
authors: AI
authors: Lopes
authors: Ana Isabel Lopes, Centro Académico de Medicina de Lisboa, Faculdade de Medicina da Universidade de Lisboa, 749-016 Lisboa, Portugal.
authors: Filipa F
authors: FF
authors: Vale
authors: Ana Isabel Lopes, Centro Académico de Medicina de Lisboa, Faculdade de Medicina da Universidade de Lisboa, 749-016 Lisboa, Portugal.
authors: Mónica
authors: M
authors: Oleastro
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000032:analysis; D001431:Bacteriological Techniques / Q000379:methods; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy; D001944:Breath Tests; D024881:Drug Resistance, Bacterial; D005243:Feces / Q000737:chemistry; D005773:Gastroscopy / Q000379:methods; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification* / Q000378:metabolism; D006801:Humans; D008826:Microbial Sensitivity Tests; D025202:Molecular Diagnostic Techniques; D011237:Predictive Value of Tests; D012698:Serologic Tests; D013270:Stomach / Q000382:microbiology* / Q000473:pathology; D014508:Urea / Q000378:metabolism; D014510:Urease / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D015415:Biomarkers; D014508:Urea; D014510:Urease
keywords: Culture; Diagnosis; Endoscopy; Helicobacter pylori; Histology; Molecular methods; Serology; Stool antigen test; Urea breath test