Usefulness of a delayed test for the diagnosis of Helicobacter pylori infection in bleeding peptic ulcer.

Abstract:

AIM:To evaluate (i) the diagnostic usefulness of a delayed test in initially negative patients; and (ii) the reliability of the rapid urease test, histology or a combination of the two to diagnose Helicobacter pylori during emergency endoscopy in a large clinical practice series. PATIENTS AND METHODS:Records of patients with ulcer bleeding from 1995 to 2000 were reviewed. Patients with initially negative tests were retested 4-8 weeks after the bleeding episode. Sensitivity of urease, histology or a combination of the two to detect H. pylori at initial endoscopy and the efficacy of delayed Urea Breath Test in detecting missed infection was determined. RESULTS:The study included 429 patients. A delayed second test detected H. pylori infection in 57 out of 72 (79%) of initially negative patients. The sensitivity for detecting H. pylori was 76%, 78% and 86% for urease, histology and their combination, respectively. The prevalence of H. pylori was 95% in duodenal and 88% in gastric ulcer. In addition, only one test was performed in 17 of the 32 patients who were considered negative. CONCLUSION:Not even the combination of a negative urease and histology in the initial endoscopy is able to rule out infection in bleeding ulcer patients. A delayed test should be performed to rule out Helicobacter pylori infection completely.

journal_name

Aliment Pharmacol Ther

authors

Güell M,Artigau E,Esteve V,Sánchez-Delgado J,Junquera F,Calvet X

doi

10.1111/j.1365-2036.2006.02726.x

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

53-9

issue

1

eissn

0269-2813

issn

1365-2036

pii

APT2726

journal_volume

23

pub_type

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