Peptic ulcer other diagnostic studies
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Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: : Manpreet Kaur, MD [2]
Overview
Testing of H.pylori infection is very important for treating ulcers. H.pylori is tested by 2 methods, invasive and non-invasive. Rapid urease testing is invasive test which is used as diagnostic study of choice. Stool monoclonal antigen test is one of the non-invasive test which is used to diagnose active infection.
Other diagnostic studies
Testing of H.pylori infection is very important for treating ulcers.H.pylori is tested by 2 methods : invasive and non-invasive tests.[1][2]
Invasive tests
- Invasive tests are diagnostic of H.pylori infections
- This includes endoscopy with biospy,histology and culture helps to diagnose peptic ulcer disease and ruling out cancer
- Rapid urease testing is diagnostic study of choice[3] [4][5][6][7][8]
| Endoscopic testing | Prerequisites |
|---|---|
| Rapid urease testing | Patients who have not been on a PPI within 1-2 weeks or an antibiotic or bismuth within 4 weeks of endoscopy |
| Histology | Patients who have been taking a PPI, antibiotics, or bismuth, endoscopic testing should include biopsies from the gastric body and antrum |
| Culture and Polymerase Chain Reaction | Not routinely recommended |
Noninvasive tests
- Urea breath test (carbon 13) tests:Urea breath test used to document eradication therapy and should be performed four to six weeks after completion of eradication therapy
- Proton pump inhibitors (PPIs) should be stopped for two weeks before the test
- Requires the ingestion of urea labeled with the nonradioactive isotope Carbon 13 or Carbon 14
- Stool monoclonal antigen tests:
| Non-invasive testing | Comments | |
|---|---|---|
| Urea breath tests | Provide reliable means of identifying active H. pylori infection before antibiotic treatment and is the most reliable nonendoscopic test to document eradication of infection | |
| Serological testing | Limited use in low prevalence H. pylori populations | |
| Stool monoclonal antigen | Enzyme immunoassay | Used to detect active infection and can be used to document eradication of infection |
| Immunochromatography | ||
| Antibody tests | ||
References
- ↑ Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology (2007). "American College of Gastroenterology guideline on the management of Helicobacter pylori infection". Am J Gastroenterol. 102 (8): 1808–25. doi:10.1111/j.1572-0241.2007.01393.x. PMID 17608775.
- ↑ Thijs JC, van Zwet AA, Thijs WJ, Oey HB, Karrenbeld A, Stellaard F, Luijt DS, Meyer BC, Kleibeuker JH (1996). "Diagnostic tests for Helicobacter pylori: a prospective evaluation of their accuracy, without selecting a single test as the gold standard". Am. J. Gastroenterol. 91 (10): 2125–9. PMID 8855734.
- ↑ Lieberman D, Fennerty MB, Morris CD, Holub J, Eisen G, Sonnenberg A (2004). "Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository". Gastroenterology. 127 (4): 1067–75. PMID 15480985.
- ↑ Delaney B, Ford AC, Forman D, Moayyedi P, Qume M (2005). "Initial management strategies for dyspepsia". Cochrane Database Syst Rev (4): CD001961. doi:10.1002/14651858.CD001961.pub2. PMID 16235292.
- ↑ Lieberman D, Fennerty MB, Morris CD, Holub J, Eisen G, Sonnenberg A (2004). "Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository". Gastroenterology. 127 (4): 1067–75. PMID 15480985.
- ↑ Marmo R, Rotondano G, Piscopo R, Bianco MA, Russo P, Capobianco P, Cipolletta L (2005). "Combination of age and sex improves the ability to predict upper gastrointestinal malignancy in patients with uncomplicated dyspepsia: a prospective multicentre database study". Am. J. Gastroenterol. 100 (4): 784–91. doi:10.1111/j.1572-0241.2005.40085.x. PMID 15784019.
- ↑ Talley NJ, Vakil N, Practice Parameters Committee of the American College of Gastroenterology (2005). "Guidelines for the management of dyspepsia". Am J Gastroenterol. 100 (10): 2324–37. doi:10.1111/j.1572-0241.2005.00225.x. PMID 16181387.
- ↑ Mamel JJ (1991). "Use of endoscopy in peptic ulcer disease". Med. Clin. North Am. 75 (4): 841–51. PMID 2072790.
- ↑ Korkmaz H, Kesli R, Karabagli P, Terzi Y (2013). "Comparison of the diagnostic accuracy of five different stool antigen tests for the diagnosis of Helicobacter pylori infection". Helicobacter. 18 (5): 384–91. doi:10.1111/hel.12053. PMID 23551920.
- ↑ Odaka T, Yamaguchi T, Koyama H, Saisho H, Nomura F (2002). "Evaluation of the Helicobacter pylori stool antigen test for monitoring eradication therapy". Am. J. Gastroenterol. 97 (3): 594–9. doi:10.1111/j.1572-0241.2002.05535.x. PMID 11922552.
- ↑ Shimoyama T, Sawaya M, Ishiguro A, Hanabata N, Yoshimura T, Fukuda S (2011). "Applicability of a rapid stool antigen test, using monoclonal antibody to catalase, for the management of Helicobacter pylori infection". J. Gastroenterol. 46 (4): 487–91. doi:10.1007/s00535-011-0371-4. PMID 21264478.
- ↑ Erzin Y, Altun S, Dobrucali A, Aslan M, Erdamar S, Dirican A, Kocazeybek B (2005). "Evaluation of two enzyme immunoassays for detecting Helicobacter pylori in stool specimens of dyspeptic patients after eradication therapy". J. Med. Microbiol. 54 (Pt 9): 863–6. doi:10.1099/jmm.0.45914-0. PMID 16091438.
- ↑ Asfeldt AM, Løchen ML, Straume B, Steigen SE, Florholmen J, Goll R, Nestegard O, Paulssen EJ (2004). "Accuracy of a monoclonal antibody-based stool antigen test in the diagnosis of Helicobacter pylori infection". Scand. J. Gastroenterol. 39 (11): 1073–7. doi:10.1080/00365520410007944. PMID 15545164.