Endoscopic Detection of Helicobacter pylori by the Rapid Urease Test

Helicobacter pylori infection can be detected on endoscopic biopsy of the gastric mucosa, by means of several techniques. The biopsy specimens are usually taken from the prepyloric region, but additional biopsy specimens obtained proximally increase the sensitivity of invasive tests and are recommended, especially if the patient has recently been treated with a proton-pump inhibitor. The effects of an increased risk of sampling error and the lower prevalence of H. pylori infection on the diagnostic accuracy of standard invasive tests needs to be considered. Despite evidence of enhanced yield with additional biopsies, combined Rapid Urease Tests (RUTs) have not been widely adopted. The other endoscopic tests, histology , and culture are also prone to sampling error and adoption of appropriate biopsy protocols should be widely adopted to enhance diagnostic yield.