Infezioni da H.pylori. Diagnosi: il ruolo del gastroenterologo

Diagnosis of H. pylori infection: the role of gastroenterologist Helicobacter pylori (H. pylori) infection can be diagnosed by invasive techniques requiring endoscopy and biopsy (histological examination, rapid urease test, culture) and by non invasive techniques (serology, urea breath test, detection of H. pylori antigen stool specimen).At present, no single test can be absolutely relied upon to detect colonization by H. pylori and a combination of two tests is recommended if feasible.Nevertheless, in routine dayto- day clinical practice H. pylori diagnosis is often by a single test and consequently the choice of the more suitable test is even more important. Choosing among them is not easy, and several issues need to be considered, such as the clinical situation, (i.e. present symptoms and past medical history, age of patients, if it is first diagnosis or follow-up after treatment..), sensitivity and specificity of the test, the cost-effectiveness of the testing strategy, the availability of the test, the local expertise . Since the “Ideal test” is not relied, the gastroenterologist or clinician as well, has the important role of deciding which test to employ. A good knowledge of advantages and vantages of each test is so necessary to make the best choose as possible.