Comparison of Different Diagnostic Modalities for Helicobacter pylori Infection in Patients with Functional Dyspepsia and Peptic Ulcer Disease.

Abstract

Background: There are several diagnostic techniques for detecting Helicobacter pylori, the most common of which are upper GI endoscopic biopsies and stool specimens as optimal sam-ples. The goal of this study was to detect and compare H. pylori infection using the following tech-niques: rapid urease test (RUT), polymerase chain reaction (PCR), culture, histopathology, and stool antigen test (SAT), as well as to assess their validity in detecting H. pylori infection.

Methodology: Patients with dyspepsia who presented to the Department of Gastroenterology's Out-patient Department and In-Patient Department between September 2021 and December 2022 were screened (Rome IV criteria). Endoscopy was used to diagnose and recruit patients with Functional dyspepsia (FD) and Peptic ulcer disease (PUD). Each biopsy sample was subjected to a battery of microbiological testing. Patients were considered infected with H. pylori if any three of five tests were found to be positive. The outcomes of all diagnostic modalities were documented and analysed.

Results: A total of 171 patients were enrolled; the majority of them were male (62.60%), with a median age of 43 years. In 120 cases (70.18%), H. pylori was identified. The RUT showed the following results: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy: 91.67%, 74.51%, 89.43%, 79.17%, and 86.55%; PCR (ureC gene): 91.67%, 100%, 100%, 83.61%, and 94.15%; Histopathology: 61.67%, 100%, 100%, 52.58%, and 73.10%; and SAT: 87.50%, 94.12%, 97.22%, 76.19%, and 89.47%, respectively.

Conclusion: The present study sheds light on the various diagnostic modalities and their efficacy in detecting H. pylori infection. Since several diagnostics are available for detecting H. pylori infec-tion, the question of which method to use arises. Thus, the sensitivity, specificity, availability, ra-pidity in obtaining results, and availability of the test, with added value such as detection of patho-genic qualities, must all be considered.