Helicobacter pylori (H. pylori) is a widespread bacterial infection that affects the stomach lining and is a leading cause of peptic ulcers, chronic gastritis, and even gastric cancer. Accurate and timely H. pylori detection is essential to ensure appropriate treatment and reduce the risk of long-term gastrointestinal complications.
However, not all H. pylori testing methods are created equal. As clinical standards evolve, outdated methods like H. pylori serology tests no longer meet the demands of modern diagnostics, and continuing to use them could do more harm than good.
Outdated Serology: An Unreliable Tool for H. pylori Detection
Historically, Helicobacter pylori testing included blood-based antibody tests (serology), which detect antibodies against the bacterium. But these antibodies can remain in the body even after the infection has cleared, making it impossible to differentiate between a current and past infection.
This limitation presents two significant clinical risks:
- False positives: Patients may receive unnecessary treatment, contributing to antibiotic resistance.
- False negatives: Active infections may go undetected, increasing the likelihood of serious complications such as gastric malignancies.
- Clinical Guidelines Recommend Against Serology
Major medical societies have issued clear guidance on H. pylori testing:
- The American College of Gastroenterology (ACG)
- The American Gastroenterological Association (AGA )
Both organizations recommend against using serology for H. pylori active infection diagnosis. Instead, they endorse non-invasive testing methods with higher accuracy:
- The H. pylori urea breath test (UBT)
- The H. pylori stool antigen test (SAT)
These tests are far superior in confirming active H. pylori infection, which is crucial for selecting the right treatment and ensuring clinical success.
Why Labs Should Stop Using Serology for H. pylori Testing
Continuing to use serology for H. pylori testing can result in:
- Misdiagnosis and delayed treatment
- Unnecessary prescriptions
- Reduced laboratory credibility
- Denied reimbursement from health plans
- Most insurance providers now label H. pylori serology testing as not medically necessary, reflecting the shift in clinical best practices.
A Better Way Forward: Accurate H. pylori Detection Tools
Modern, non-invasive tools like the BreathID® Urea Breath Test and the Curian® HpSA® stool antigen test provide accurate, efficient, and reimbursable solutions for diagnosing active H. pylori infections. The BreathID system delivers rapid, real-time breath test results, while Curian uses advanced fluorescent immunoassay technology to provide fast, objective, and reliable results—empowering labs to support clinicians with confidence.
Conclusion: Make the Switch to Better H. pylori Testing
The science is clear: Helicobacter pylori testing must evolve. Serology is no longer a viable option for H. pylori detection and should be phased out in favor of proven, guideline-supported methods like the H. pylori urea breath test and H. pylori stool antigen testing.