[Diagnosis of Helicobacter pylori infection]

Direct or indirect methods are available to diagnose Helicobacter pylori infection. Direct assessment with histopathology, culture, rapide urease test, amplification of gene sequences requires the collection of biopsy samples via an endoscope. Culture is the gold standard, but histopathology is commonly used in clinical practice. Serology, 13C-urea breath test and detection of antigens in stools are indirect methods. In clinical practice, direct assessment is required for the initial diagnosis as only patients with endoscopic lesions need H. pylori eradication. Among indirect methods, serology should be used only in epidemiologic studies. Urea breath test and detection of antigens in stools are the most appropriate methods to assess eradication.