There are two basic ways to diagnose infection with H. pylori, the bacteria that cause most peptic and duodenal ulcers: either by passing a fiberoptic tube down the esophagus and into the stomach (called an EGD, or esophagogastroduodenoscopy) or by doing noninvasive tests.
The EGD is performed by a gastroenterologist and requires light anesthesia. The most accurate diagnosis is obtained by taking biopsies during the endoscopic exam, which is rather painless.
The real advantage is that it also allows the doctor to examine the stomach and esophageal lining, thereby checking for erosions, gastric atrophy, and malignancy.
Noninvasive testing can involve a stool antibody test, blood antibody test, or a breath test.
The fastest is a breath test, which has a high specificity and sensitivity rating. It entails merely drinking a mixture and then blowing into a small bag.
The breath test measures a gas released by the H. pylori bacteria in large amounts. The results come back the next day.
Another advantage of the breath test is that it can be used after treatment to see if the organism has been eradicated.
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