080 - Diagnosis of Helicobacter pylori infection: invasive and non-invasive tests
Autor(s): M. Salvagnini
Issue: RIMeL - IJLaM, Vol. 4, N. 2, 2008 (MAF Servizi srl ed.)
Page(s): 80-83
The knowledge of implication of Helicobacter pylori infections in various digestive (duodenal and gastric ulcers, gastric carcinoma, gastric MALT lymphoma, dyspepsia) and extra intestinal diseases (idiopathic thrombotic purpura, iron deficient anaemia) has been followed from more wide test availability for Helicobacter pylori identification. The tests can be applied to bioptic material (invasive tests) or to other organic sample (noninvasive tests). Several studies and consensus reports have recognized the Urea Breath Test as the most useful in clinical practice, proposing Helicobacter pylori antigen in faeces as the alternative one, showing both a sensitivity >90%. The serological test maintains a strong indication only in situations where urea breath test and Helicobacter pylori antigen in faeces are reported to have a large proportion of false negative (i.e. haemorrhages from gastric and duodenal ulcer and during treatment with proton pump inhibitors). Invasive tests, including also rapid tests, should be performed in case of clinical indication for endoscopic procedures, meanwhile the culture of Helicobacter pylori is indicated when at least two cycles of eradicant therapy with different antibiotics failed in eradicating the bacteria.