Optimizing the searching for H. pylori in clinical practice with EndoFaster^Ⓡ

H. pylori plays a major role in gastroduodenal diseases. Since its incidence is decreasing in developed countries, gastric biopsies were negative in several patients managed in clinical practice. We tested whether EndoFaster^Ⓡ - a device allowing real-time H. pylori detection by gastric juice analysis - may optimize the need of biopsies.

In this prospective, multicentre study, the accuracy of EndoFaster^Ⓡ for H. pylori detection was computed by using histology of gastric biopsies as a gold standard.

Data of 525 consecutive patients were available, including 90 (17.1%) patients with infection. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of EndoFaster^Ⓡ were 87%, 84%, 53%, 97% and 85%, respectively. The overall accuracy of test was not affected neither by ongoing proton pump inhibitor therapy nor by previous eradication therapy. By using EndoFaster^Ⓡ in our series, biopsy sampling could have been eventually avoided in a total of 279 patients, accounting for a reduction of 42.3%, accepting the risk of only 8 false negative cases.

The very high NPV of EndoFaster^Ⓡ might allow to safely halve the need of taking gastric biopsies in unselected patients managed in clinical practice, avoiding an unavailing consume of health resources.