There are numerous tests that aid in the diagnosis of infection by H. pylori. It is important to note that the appearance of the gastric mucosa is not sufficient evidence for the diagnosis of H. pylori infection. Tests used in diagnosis include:
1) BIOPSY AND STAINING OF THE MUCOSA - A biopsy and histological exam of the mucosa have for long been the most accurate method of diagnosis. Microscopy of slides with hematoxtlin, eosin, Gram, Giemsa, Genta, or Warthin Starry stain have also proven very useful in he diagnosis process.
2) UREASE TESTS - Rapid urease tests have been performed on specimens of gastric mucosa in order to diagnose infection by H. pylori. This test employs a urea-rich medium with a pH sensitive dye. In the presence on urea, the urea is hydrolyzed to ammonia and the dye changes color. While this is a less expensive form of diagnosis, physician must be weary of the possibility of false negatives and positives.
3) ANALYSIS OF CIRCULATING IgG ANTIBODY RESPONSE: The amount of circulating IgG and IgA can be measured in saliva or plasma, detecting mucosal immune responses induced by H. pylori. These tests are reliable and fast but incapable of confirming a cure.
4) BREATH TESTS: This test requires patients to ingest urea radioactively labeled with 13 C or 14 C. In patients infected with H. pylori, the excess urease will convert this urea to carbon dioxide, which can be detected from breath once it has entered the blood.
Many who play host to H. pylori will remain asymptomatic. The lack of symptoms may be associated with less virulent strains of H. pylori. For those who do experience infection by this bacteria, symptoms will mimic those seen in patients suffering from gastric ulcers, duodenal ulcers, or chronic gastritis. These include: