Charter Medical Services

Helicobacter test & treat strategies will benefit patients with ulcer disease, 8% of patients with functional dyspepsia, and reduce future risk of ulcer disease, gastric cancer and risks of long-term PPIs.

Currently NICE guidelines suggest "Test and Treat" - patients with dyspepsia and no alarm symptoms (and under 50y) should have a HP blood or stool antigen test, and if positive be offered treatment (usually triple therapy). Endoscopy should be performed if alarm symptoms are present.

• Persistent symptoms on treatment
• Abdominal mass
• History of bleeding
• Previous gastric ulcer
• Previous gastric surgery
• Abnormal radiography
• History of Barretts oesophagus.

False negatives can be expected if PPIs or Antibiotics are used within 14 days. Antigen tests cannot differentiate past or current infection (will remain positive after successful eradication). To detect active infection there are currently two tests - Urea breath test (UBT) and in vitro testing at endoscopy (CLO test for example).