Helicobacter pylori : tests

The presence of Helicobacter pylori (H. pylori) should be confirmed before starting eradication treatment, following a 'test and treat' strategy. This approach ensures that treatment is only given to patients with a confirmed infection, thereby avoiding unnecessary use of antibiotics and reducing the risk of antibiotic resistance.

Testing for H. pylori is recommended in the following patients, in line with Public Health England (PHE) guidance:

1. Patients with Uncomplicated Dyspepsia: Those with no alarm symptoms who are unresponsive to lifestyle changes and antacids, following a single one-month treatment course with a proton pump inhibitor.
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3. High-Risk Patients: Individuals considered at high risk of H. pylori infection, such as older people, individuals of North African ethnicity, and those living in known high-risk areas, should be tested for H. pylori infection first or in parallel with a course of a proton pump inhibitor.
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5. Patients with a History of Peptic Ulcers or Bleeds: Previously untested patients with a history of peptic ulcers or gastrointestinal bleeding.
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7. Prior to Initiating NSAIDs: Patients with a prior history of peptic ulcers or bleeds should be tested before starting nonsteroidal anti-inflammatory drugs (NSAIDs).
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9. Unexplained Iron-Deficiency Anaemia: Patients with unexplained iron-deficiency anaemia after endoscopic investigation has excluded malignancy, and...