Fast Five Quiz: Helicobacter pylori

B.S. Anand, MD; Steven F. Moss, MD


January 20, 2022

Guidelines from the American College of Gastroenterology (ACG) recommend testing for H pylori infection in patients with unexplained iron deficiency anemia. Consideration of testing in adults with idiopathic thrombocytopenic purpura is also recommended.

The H pylori fecal antigen test is both highly specific (98%) and sensitive (94%) at detecting H pylori infection. The carbon-13 urea breath test can also be used with good reliability.

H pylori serology has high (greater than 90%) specificity and sensitivity and can be useful for detecting an infected patient; however, it is not a good test for assessing whether eradication therapy was successful because the results do not indicate active infection. The antibody titer may remain elevated for an extended period following H pylori eradication.

Testing is not indicated in patients with typical symptoms of gastroesophageal reflux disease unless there is a history of PUD or dyspeptic symptoms.

Learn more about the workup for H pylori.


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