Consideraciones prácticas para el diagnóstico de la infección por Helicobacter pylori

Argila, Carlos Martín de; Boixeda, D

doi:10.1016/s0025-7753(01)72122-7

Cited by 10 publications

(8 citation statements)

References 65 publications

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“…The urease rapid test can be considered the diagnostic method of choice in these patients requering endoscopy, because of its simplicity, diagnostic accuracy and rapidity of results (18,19), although decreased sensitivity has been reported in cases of bleeding duodenal ulcer (6,11,13,(20)(21)(22). In such cases, histology, simultaneous urease test and histology, or C 13 breath test after a hemorrhagic event (with no invasive test being performed) have been proposed by some authors (7,10).…”

Section: Discussionmentioning

confidence: 99%

“…The cause for this decreased diagnostic sensitivity of the urease test in cases of bleeding duodenal ulcer remains controversial. Several circumstances have been considered to explain this fact, such as the presence of blood in the stomach, which might induce a transient mucosal bacterial clearance because of a bactericide effect of the serum (7,25). Another possibility is that serum albumin may induce a buffering effect on the pH indicator used for urease testing, which might prevent color change (26).…”

Section: Discussionmentioning

confidence: 99%

“…El test rápido de la ureasa, en estos pacientes que requieren endoscopia, se puede considerar como el método diagnóstico de elección, por su sencillez, precisión y rapidez del resultado (18,19), aunque presenta una disminución de la sensibilidad diagnóstica en los casos de úlcera gastroduodenal con hemorragia digestiva (6,11,13,(20)(21)(22). En estos casos se ha recomendado por algunos autores practicar histología, con menor pérdida de sensibilidad (23), en vez del test de la ureasa, practicar simultáneamente test de ureasa e histología, o no practicar ningún test invasivo y realizar el test del aliento con 13 C tras superarse el episodio hemorrágico (7,10).…”

Section: Discussionunclassified

“…Patients with gastroduodenal ulcer may develop complications such as upper gastrointestinal bleeding or perforation, which calls for a precise diagnosis of H. pylori infection since eradication reduces significantly the risk of ulcer reactivation, and thus prevents new episodes of upper gastrointestinal bleeding (3)(4)(5). Several diagnostic methods for H. pylori infection are available, either invasive -which require endoscopy and gastric biopsies (urease rapid test, histology and cultures)-or non-invasive (urea C 13 breath test, stool antigen detection and serology), all of them exhibiting both advantages and disadvantages regarding availability, rapidity of results, value, and diagnostic accuracy (6)(7)(8)(9). Invasive methods, specially the urease rapid test, show decreased sensitivity in cases of bleeding gastroduodenal ulcers (6)(7)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

“…Los pacientes con enfermedad ulcerosa gastroduodenal pueden presentar complicaciones, como hemorragia digestiva o la perforación y es necesario realizar un diagnóstico preciso de la infección por H. pylori, ya que su erradicación reduce considerablemente la posibilidad de recidiva ulcerosa y de nuevos episodios de hemorragia digestiva (3)(4)(5). Disponemos de varios métodos diagnósticos de infección por H. pylori, bien invasivos, que precisan la práctica de gastroscopia y biopsias gástricas (test rápido de la ureasa, histología y cultivo) o no invasivos (test del aliento con urea 13 C, detección de antígenos en heces y serología), presentando todos ellos ventajas e inconvenientes, en relación a disponibilidad, rapidez en resultados, coste o precisión diagnóstica (6)(7)(8)(9). Los métodos invasivos, especialmente el test rápido de la ureasa, muestra una pérdida de sensibilidad en los casos de úlcera gastroduodenal complicada con hemorragia digestiva (6)(7)(10)(11)(12)(13)(14).…”

Section: Introductionunclassified

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Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies

Fernández

Muñoz

Díaz

et al. 2004

Rev. esp. enferm. dig.

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Introduction: the sensitivity of invasive diagnostic methods for Helicobacter pylori (H. pylori) infection, particularly of urease rapid test, is decreased in cases of gastroduodenal ulcer and upper gastrointestinal bleeding.Objectives: to assess the influence of blood in the stomach or recent bleeding endoscopic signs in the diagnostic sensitivity of urease rapid test among patients with bleeding duodenal ulcer, as well as the influence of simultaneously collected corporal and antral biopsy samples.Patients and methods: 120 patients, 85 male and 35 female, with an average age of 62 (18-88) years, who were admitted to our Hospital due to bleeding duodenal ulcer and who received an endoscopic diagnosis within 24 hours of admission were included. None of the patients had been under treatment with non-steroideal antiinflammatory drugs, proton-pump inhibitors or antimicrobial drugs in the two weeks prior to the bleeding event, and none had received eradicating therapy for H. pylori. In this group of selected patients an H. pylori infection rate nearing 100% was assumed. H. pylori infection was ruled out using antral biopsy (69 cases) or both antral and fundic biopsies (51 cases) for urease rapid testing (Jatrox®-H.p.-Test). Patients were classified in three groups according to their endoscopic bleeding signs: a) presence of blood in the stomach or recent bleeding ulcer (21 cases); b) ulcer showing non-recent bleeding signs (38 cases); and c) ulcer without bleeding signs (61 cases). The sensitivity of the urease rapid test was compared between patient groups. Similarly, urease test results with an antral biopsy sample were compared in 100 patients with non-bleeding duodenal ulcer.Results: urease test was positive in 93% of patients with nonbleeding duodenal ulcer, and in 83% of patients with upper gastrointestinal bleeding, which reached statistical significance (p = 0.019). This test was positive in 82.6% of patients with an antral biopsy, and in 82.3% of patients with combined antral and fundic biopsies. In group A, urease test was positive in 90.5% of patients; in group B, it was positive in 89.5% of patients, and in group C, the test turned positive in 75.4% of patients. Statistical differences were only reached when patients in group C were compared to patients in groups A and B together (p = 0.037). Conclusions:1. The presence of either blood in the stomach or recent bleeding endoscopic signs appeared not to be the conditioning factor for the decreased sensitivity of urease test among patients with bleeding duodenal ulcer.2. The decreased sensitivity of this test in patients with upper gastrointestinal bleeding is more evident during the resolution stage, and it does not seem to occur because of H. pylori migration from the antrum to the corporal gastric region.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

Section: Introductionmentioning

confidence: 99%

Section: Introductionunclassified

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Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies

Fernández

Muñoz

Díaz

et al. 2004

Rev. esp. enferm. dig.

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Takwoingi

Siddique

et al. 2018

Cochrane Database of Systematic Reviews

158

130

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In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions.

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Comparación entre las biopsias gástricas con fijación inmediata y diferida para la detección de Helicobacter pylori

Cusma-Quintana

Vilela-Desposorio²,

Miñano-García³

et al. 2016

Revista Española de Patología

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Consideraciones prácticas para el diagnóstico de la infección por Helicobacter pylori

Cited by 10 publications

References 65 publications

Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies

Diagnosis of Helicobacter pylori infection using urease rapid test in patients with bleeding duodenal ulcer: influence of endoscopic signs and simultaneous corporal and antral biopsies

Non-invasive diagnostic tests forHelicobacter pyloriinfection

Comparación entre las biopsias gástricas con fijación inmediata y diferida para la detección de Helicobacter pylori

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