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Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
Published on: July 28, 2023
Traditional and Modern Diagnostic Approaches in Diagnosing Pediatric Helicobacter pylori Infection
Cristina Oana Mărginean1, Lorena Elena Meliț1, Maria Oana Săsăran2
1Department of Pediatrics I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Targu Mures, Romania.
Insights
Early diagnosis and eradication of Helicobacter pylori (H. pylori) infection are crucial for preventing gastric cancer. This review evaluates traditional and modern H. pylori diagnostic methods, highlighting their strengths and weaknesses for effective clinical use.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Helicobacter pylori (H. pylori) is a prevalent global infection, often acquired in childhood, linked to adult gastric cancer.
- Effective H. pylori diagnosis and eradication are vital for gastric cancer prevention strategies.
Purpose of the Study:
- To review and assess traditional and contemporary diagnostic methods for H. pylori infection.
- To compare the efficacy, accessibility, and cost-effectiveness of various diagnostic approaches.
Main Methods:
- Review of invasive diagnostic techniques: endoscopy with biopsy, rapid urease tests, histopathology, cultures, and molecular tests.
- Review of non-invasive diagnostic techniques: urea breath tests, serology, stool antigen tests, and non-invasive molecular tests.
Main Results:
- Histology is a widely available, accurate, and cost-effective invasive method.
- Molecular tests offer the highest accuracy among invasive methods but are costly.
- Urea breath tests and stool antigen tests are highly practical for diagnosing H. pylori and monitoring treatment success.
Conclusions:
- The selection of an appropriate H. pylori diagnostic method depends on factors including bacterial virulence, environmental influences, and host characteristics.
- Accurate diagnosis and successful eradication of H. pylori are fundamental for gastric cancer prevention.
Abstract:
Helicobacter pylori (H. pylori) is the most common bacterial infection worldwide, is usually acquired during childhood and is related to gastric carcinogenesis during adulthood. Therefore, its early proper diagnosis and subsequent successful eradication represent the cornerstones of gastric cancer prevention. The aim of this narrative review was to assess traditional and modern diagnostic methods in terms of H. pylori diagnosis. Several invasive and non-invasive methods were described, each with its pros and cons. The invasive diagnostic methods comprise endoscopy with biopsy, rapid urease tests, histopathological exams, cultures and biopsy-based molecular tests. Among these, probably the most available, accurate and cost-effective test remains histology, albeit molecular tests definitely remain the most accurate despite their high costs. The non-invasive tests consist of urea breath tests, serology, stool antigens and non-invasive molecular tests. Urea breath tests and stool antigens are the most useful in clinical practice both for the diagnosis of H. pylori infection and for monitoring the eradication of this infection after therapy. The challenges related to accurate diagnosis lead to a choice that must be based on H. pylori virulence, environmental factors and host peculiarities.
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