Don’t request serology for Helicobacter pylori. Use the stool antigen or breath tests instead.
|Rationale and Comments:||Serologic evaluation of patients to determine the presence/absence of H. pylori infection is no longer considered clinically useful. Alternative noninvasive testing methods (e.g., the urea breath test and stool antigen test) exist for detecting the presence of the bacteria and have demonstrated higher clinical utility, sensitivity, and specificity. Additionally, both the American College of Gastroenterology and the American Gastroenterology Association recommend either the breath or stool antigen tests as the preferred testing modalities for active H. pylori infection. Finally, several laboratories have dropped the serological test from their menus, and many insurance providers are no longer reimbursing patients for serologic testing.|
|References:||• Babak Pourakbari, Mona Ghazi, Shima Mahmoudi, Setareh Mamishi, Hossein Azhdarkosh, Mehri Najafi, Bahram Kazemi, Ali Salavati, and Akbar Mirsalehian. Diagnosis of Helicobacter pylori infection by invasive and noninvasive tests. Braz J Microbiol. 2013; 44(3): 795–798. Published online 2013 Nov 15.
• Elvira Garza-González, Guillermo Ignacio Perez-Perez, Héctor Jesús Maldonado-Garza, and Francisco Javier Bosques-Padilla. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World J Gastroenterol. 2014 Feb 14; 20(6): 1438–1449. Published online 2014 Feb 14. doi: 10.3748/wjg.v20.i6.1438
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