Optimization of diagnosis of Helicobacter pylori infection: selective rapid urease tests and ammonium breath test

The issues of optimizing the management of patients infected with Helicobacter pylori have remained relevant in clinical therapy and gastroenterology for many years. This is due both to the high prevalence of H. pylori infection in Russia: depending on the region, it is 35–60 %, and to the potential carcinogenicity of the microorganism in relation to the development of gastric cancer. According to clinical recommendations, when conducting an endoscopic examination of the upper gastrointestinal tract, a rapid urease test with biopsy samples from the antrum and body of the stomach or histological examination of biopsies of the gastric mucosa may be recommended as a method of primary diagnosis of infection, and a 13C-urease breath test or determination of the antigen of a microorganism in feces is recommended as a non-invasive diagnostic. The use of rapid urease tests with selectivity for H. pylori , which do not respond to pH changes and to the urease of other urease producents. For non-invasive diagnostics, alternative ways of verifying the microbe can also be considered, for example, an ammonium breath test, when the level of CO 2 in the exhaled air is not determined, but the second metabolite of urea hydrolysis – ammonia.