Ways to improve the negative impact of proton pump inhibitors on biopsy-based test accuracy for Helicobacter pylori detection

Description

Malfertheiner and Schulz commented in 2025 on how to keep stomach biopsy tests accurate for Helicobacter pylori when patients cannot stop acid-blocking drugs. Proton pump inhibitors cut the accuracy of nearly every test for this stomach infection, so guidelines ask patients to stop them two weeks before testing, which real practice often cannot manage. The commentary discusses a study of 164 dyspeptic patients that sought a fix while the drugs continued.

Gene-based PCR testing proved most accurate and lost nothing on the drugs, since it needs only traces of bacterial DNA, but cost and availability limit its use. The study's practical trick, pooling paired biopsies from two stomach regions into a single rapid urease test sample, raised the routine test's yield against the PCR standard. The commentators endorse PCR where feasible and the pooled-biopsy workaround elsewhere, so treatable infections are not missed.

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Source: https://europepmc.org/article/MED/PMC13272270