[Invasive diagnosis of Helicobacter pylori infection in the 2006 clinical practice]

Currently, different approaches are employed to detect the presence of Helicobacter pylori (H. pylori): invasive, if based on biopsies performed during endoscopy (urease test, histology, culture, polymerase chain reaction), and non-invasive, if endoscopy is not carried out. Another option is offered by the invasive non-endoscopic methods (string test). An update on the diagnostic invasive approaches to patients in the clinical setting is presented in this review. Although non-invasive tests are preferred, important information can be gained from histology, the unique technique which permits the evaluation of the status of the mucosa, and from culture, that allows strain typing and tests for antibiotic susceptibility. Until today, polymerase chain reaction has had a limited application in the clinical practice and the role of non-endoscopic methods needs to be better clarified in the future.