It has been a little more than 12 years since my current colleague, Barry Marshall, first rediscovered Helicobacter pylori infection and a little more than one year since the NIH Consensus Conference concluded that ulcer disease is an infectious disease and that, as with any other infectious disease, the infection must be diagnosed and treated. The bottom line is that, to be cost effective, any diagnostic strategy we employ must be used very selectively and appropriately. Largely due to the proliferation of a large number of tests available to diagnose this infection, physicians are faced with a diagnostic dilemma.
Serology is a very attractive test.
This enables us to make a diagnosis within a primary care setting. One can also detect the Cag-A protein serologically. The development of office-based tests represents a real step forward in serology. These tests can be performed with either a drop of serum or a drop of blood and they very quickly detect the presence of antibodies. IgG and IgA antibodies can both be utilized either in a central laboratory or in the office setting.