There are a variety of diagnostic tests available for H. pylori detection. Histopathology is invasive and costly and not practical for following response to therapy. Likewise urea-based tests on tissue still require an initial invasive endoscopic procedure. These assays are the most reliable tests for active infection. 13 C and 14 C breath tests are noninvasive, but are quite expensive because of the need for special equipment.
Serology requires only venipuncture, but is an unreliable test for active disease.
The stool antigen test has the advantage of being non-invasive, a good marker for active infection, and is relatively inexpensive compared to endoscopic biopsy and breath tests. Helicobacter pylori . Kozak K, et al. Detection of Helicobacter pylori antigen in stool specimens using a novel enzyme immunoassay. Helicobacter pylori in peptic ulcer disease.