RETESTING FOR H. PYLORI

How often do patients who have been treated for Helicobacter pylori infections have to be retested? I know the antibodies can persist, and I hate for patients to have repeat endoscopy for this purpose. Is it possible just to retest at specified intervals?
—Neal M. Davis, DO, Carbondale, Pa.

Serology for H. pylori can remain positive for months to years, and therefore, it cannot be used to confirm post-treatment eradication. There are two noninvasive tests that can be used as alternatives to endoscopy and biopsy: the urea breath test and the stool antigen test. Testing once is adequate, at least four to six weeks after treatment, and ideally off proton-pump-inhibitor therapy for one to two weeks and off any antibiotics or bismuth products for four weeks to avoid false-negative results.
—Christina M. Surawicz, MD (115-2)

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