Urea breath test and stool antigen test are better than serological tests

Managing dyspepsia costs the NHS over £500m annually.1 European dyspepsia guidelines and those from the National Institute for Clinical Excellence (NICE) say that patients with persistent or recurrent uncomplicated dyspepsia should have a non-invasive Helicobacter pylori test and, if the test is positive, receive triple therapy.2^–4 With a policy requiring non-invasive testing and treatment we need to use an accurate test so that the patients receive the correct treatment. The urea breath test and serology were the first non-invasive tests available; the urea breath test is the more accurate. This test detects products of the enzyme urease produced by live H pylori in the stomach and is 95% sensitive and specific.5 The breath test has not been used much in primary care in the United Kingdom, probably because it is time consuming as it requires two breath samples, taken 20 minutes apart.

Serology is the …