II. Indications

  1. Dyspepsia evaluation
  2. Confirmation of cure after H. pylori management

III. Mechanism

  1. Measures H. pylori antigen present in stool sample

IV. Efficacy

  1. Stool monoclonal antigen tests (enzyme immunoassay)
    1. Test Sensitivity: 92%
    2. Test Specificity: 94%
    3. Most accurate, but more expensive than immunochromatography
  2. Stool monoclonal antigen tests (Immunochromatography)
    1. Test Sensitivity: 69-87%
    2. Test Specificity: 87-93%
    3. Variable reliability, but available for office based testing
  3. Accurate for confirmation of cure at 7 days
    1. Antigen levels significantly suppressed with cure
    2. Vaira (2002) Ann Intern Med 136:280-7 [PubMed]

V. Protocol: Patient stops medications 2 weeks before test

  1. Stop Proton Pump Inhibitors (but less affected than Urea Breath Test)
  2. Stop all antibiotics
  3. Stop bismuth compounds (e.g. Pepto Bismol)

VI. Advantages

  1. Excellent first line non-invasive test for diagnosis
  2. Noninvasive test of H. pylori cure
  3. Inexpensive

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