Shrinking gaps in H.pylori management
“New Houston Consensus guidelines highlight the need for broader screening practices, recommending only non-serological assays such as UBT and HpSAg for initial diagnosis.“
ACG and CAG Clinical Guideline:
Management of Dyspepsia
“we recommend dyspepsia patients under the age of 60 should have a non-invasive test for h. pylori and therapy for h. pylori infection if positive”
“we recommend dyspepsia patients under the age of 60 should have empirical ppi therapy if they are h. pylori-negative or who remain symptomatic after h. pylori eradication therapy”
ACG Clinical Guideline:
Treatment of Helicobacter pylori Infection
“Whenever H. pylori infection is identified and treated, testing to prove eradication should be performed using a urea breath test, fecal antigen test or biopsy based testing at least 4 weeks after the completion of antibiotic therapy and after PPI therapy has been withheld for 1–2 week”
“When conducted properly, the urea breath test, fecal antigen test, and endoscopic tests all are highly sensitive and specific at detecting persistent H. pylori infection”
Maastricht V/Florence Consensus Report
Management of Helicobacter pylori infection
“The 13C-UBT is the best approach to the diagnosis of H. pylori infection,with high sensitivity and specificity, and excellent performances”
“H2 receptor antagonists have been shown to have minimal effect on the sensitivity of UBT, and antacids do not impair the sensitivity of UBT or SAT.”
“UBT is the best option for confirmation of H. pylori eradication and monoclonal SAT is an alternative. It should be performed at least 4 weeks after completion of therapy.”
AAFP – Diagnosis and Treatment
of Peptic Ulcer Disease and H. pylori Infection
“Urea breath tests and stool antigen tests are most accurate for identifying H. pylori infection and can be used to confirm cure”
“The urea breath test (carbon 13) is a reliable noninvasive test to determine whether H. pylori has been eradicated.”
