Helicobacter pylori infection

Endoscopy with gastric or duodenal biopsy (special stains) to identify Helicobacter  pylori; the urease test can be used for rapid identification of infection, but is less sensitive than histology.

Culture for sensitivity testing if recurrent or refractory disease.

Molecular genetics - microbial testing is available in some laboratories.

H. pylori antibodies provide evidence of infection, but are of limited value as a positive result does not distinguish past from current infection.

Antibody levels decline slowly after therapy.

Urease breath test can be used to identify continuing infection.