Diagnostic methods for Helicobacter pylori infection: ideals, options, and limitations

  • Parisa Sabbagh
  • Mousa Mohammadnia-Afrouzi
  • Mostafa Javanian
  • Arefeh Babazadeh
  • Veerendra Koppolu
  • VeneelaKrishna Rekha Vasigala
  • Hamid Reza Nouri
  • Soheil Ebrahimpour


Helicobacter pylori (H. pylori) resides in the stomach, colonizes gastric epithelium, and causes several digestive system diseases. Several diagnostic methods utilizing invasive or non-invasive techniques with varying levels of sensitivity and specificity are developed to detect H. pylori infection. Selection of one or more diagnostic tests will depend on the clinical conditions, the experience of the clinician, cost, sensitivity, and specificity. Invasive methods require endoscopy with biopsies of gastric tissues for the histology, culture, and rapid urease test. Among non-invasive tests, urea breath test and fecal antigen tests are a quick diagnostic procedure with comparable accuracy to biopsy-based techniques and are methods of choice in the test and treatment setting. Other techniques such as serological methods to detect immunoglobulin G antibodies to H. pylori can show high accuracy as other non-invasive and invasive biopsies, but do not differentiate between current or past H. pylori infections. Polymerase chain reaction (PCR) is an emerging option that can be categorized as invasive and non-invasive tests. PCR method is beneficial to detect H. pylori from gastric biopsies without the need for the cultures. There is no other chronic gastrointestinal infection such as H. pylori with a set of comparable diagnostic methodologies. Despite the availability of multiple diagnostic methods, it remains unclear on the choice of any one method as the gold standard for detecting H. pylori infection, especially in epidemiological studies. In this work, we review the principal diagnostic methods used to detect H. pylori infection and their advantages and disadvantages, and applications in clinical practice.


Helicobacter pylori Characteristics of infection Diagnosis Invasive tests Non-invasive tests 



The authors gratefully thank the Department of Infectious Diseases of Babol University of Medical Sciences, Iran.

Specific author contributions

P.S and S.E conceived the study; M.M.A, M. J, A. B, V. K, V.K.R.V, H.R.N, and S.E collected all data; P.S and S.E drafted the manuscript; and all authors commented on the drafts of the manuscript and approved the final draft of the paper.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study received the approval from the Babol University of Medical Science, Ethical Committee.

Informed consent

There is no informed consent for this review article.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Parisa Sabbagh
    • 1
  • Mousa Mohammadnia-Afrouzi
    • 1
    • 2
  • Mostafa Javanian
    • 1
  • Arefeh Babazadeh
    • 1
  • Veerendra Koppolu
    • 3
  • VeneelaKrishna Rekha Vasigala
    • 4
  • Hamid Reza Nouri
    • 2
  • Soheil Ebrahimpour
    • 1
  1. 1.Infectious Diseases and Tropical Medicine Research Center, Health Research InstituteBabol University of Medical SciencesBabolIslamic Republic of Iran
  2. 2.Cellular and Molecular Biology Research Center, Health Research InstituteBabol University of Medical SciencesBabolIslamic Republic of Iran
  3. 3.Scientist Biopharmaceutical Development MedimmuneGaithersburgUSA
  4. 4.Rangaraya Medical CollegeNTR University of Health SciencesKakinadaIndia

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