Endoscopic diagnosis of H. pylori infection

Helicobacter pylori (H. pylori) infection is highly prevalent in our environment and is associated with highly relevant gastric disease, both benign and malignant. The gold standard for diagnosis is histological confirmation by biopsy. However, there is increasing evidence that optical endoscopic diagnosis could have a fundamental role in avoiding unnecessary biopsies in certain cases. Specifically, the regular distribution of the collecting venules (RAC pattern) seems to have a high negative predictive value (NPV) to rule out infection. This review describes the most outstanding endoscopic findings with the best diagnostic potential for H. pylori infection after an exhaustive search comparing the most relevant studies that have been carried out in Europe and the East.