Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11221
Peer-review started: May 12, 2015
First decision: July 13, 2015
Revised: August 6, 2015
Accepted: September 28, 2015
Article in press: September 30, 2015
Published online: October 28, 2015
Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies. Molecular methods have been used in variable specimens other than gastric mucosa. More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes.
Core tip: Nowadays, several tests are available for the diagnosis of Helicobacter pylori (H. pylori) infection. In this review, we focus on the usefulness and limitations of current diagnostic methods as well as the recent developments of these tests that contribute to improve the diagnostic accuracy. Furthermore, we also emphasize the detection of H. pylori in oral specimens and in patients with different clinical circumstances, including bleeding, post-gastrectomy and post-eradication therapy.