[Diagnostic Methods for the Detection of Helicobacter Pylori Infection: Which and When to Order?]

Gastric infection by Helicobacter pylori has a variable prevalence worldwide. In Latin America, it can exceed 50% of infected people. It is associated with peptic ulcer, gastric cancer, MALT lymphoma, immune thrombocytopenic purpura, among other pathologies. There is no optimal diagnostic method, and its presence can be detected by both invasive methods that require an upper gastrointestinal endoscopy, and non-invasive methods. Within the invasive, we have the rapid urease test, histology, molecular tests such as polymerase chain reaction and culture. On the other hand, non-invasive tests include the breath test, Helicobacter pylori antigen in stools, polymerase chain reaction in stools and serology. Depending on the clinical scenario, the diagnostic test to be used, its benefits and weaknesses should be known. It is important to consider the age of the patient, their gastric cancer risk factors, the need for endoscopy for this or another reason, the availability of diagnostic tests and the cost, among others.