Analysis index

Pathogen detection: Gastric / duodenal biopsy in special transport medium

Antibody detection: 1 lm serum

PCR: Stool

IgG: < 20 U/ml

IgA: < 20 U/ml

PCR: negative

Gastritis, ventricular ulcer, duodenal ulcer, gastric MALT-lymphoma, idiopathic thrombocytopenic purpura, possibly M. Menetrier, functional dyspepsia (debated)

H. pylori prevalence in Germany is between 3 % (children) and 48 % (adults). It is markedly increased in immigrants (36 % - 86 %). 80 % of the infections are clinically symptomless. H. pylori may trigger chronic active gastritis. Potential consequences are duodenal or ventricular ulcers, adenocarcinoma of the stomach or MALT-syndrome.

Taking proton pump inhibitors (PPI) and antibiotics, reduces pathogen density. This may lead to false negative results. Therefore, diagnostics should take place no earlier than 4 weeks after antibiotic treatment and at least 2 weeks after PPI treatment. Diagnostic via culture and PCR from biopsies taken endoscopically (invasive method) or via non-invasive methods such as urea breath test, PCR, IgG- and IgA antibodies in serum.

An acute infection can be demonstrated by culture, PCR or urea breath test. A positive serological result only shows, that a previous confrontation with bacteria has taken place, it does not allow a statement about infection activity. Following sanitization, a significant fall in titer can be seen after 6 – 12 months. A false-negative serum test can be caused by missing immune answer.

A resistance test is possible from a culture from gastric- / duodenal biopsies, testing for clarithromycin resistance by PCR is also possible from those kind of biopsies or stool.

For initial diagnosis in children and for follow-up checks after eradication treatment in adults, the breath test (C13-urea breath test- only suitable for older children from the age of 8- please refer to function tests), or PCR are recommended. Checks of eradication treatment should be carried out no earlier than 4 weeks after therapy end.

 Please also refer to section “Helicobacter pylori C13 breath test”