H. pylori testing

Date: 11/12/2019

Effective 11/18/19, Northern Light Laboratory will perform Helicobacter pylori
Stool Antigen testing in-house. This was previously available as a send out to ARUP
laboratories. Ordering processes (PYLORI AG) and specimen requirements (stool) will
not change. For best results, patients should still avoid Proton Pump Inhibitors, H2
blockers and Bismuth for 14 days prior to running the test. The PYLORI AG test is cleared
to be used in patients of all ages for diagnosis, therapy monitoring and to confirm
eradication after treatment.
Northern Light Laboratory plans to phase out H. pylori Antibody testing in 2019
and will cease to offer the H. pylori IgG test in the new year. National reference
laboratories, including our referral laboratory, ARUP1, have already phased out H. pylori
serological tests. The most recent guidelines issued by the American Gastroenterological
Association (AGA) and American College of Gastroenterology (ACG) do not recommend
the use of H. pylori serological tests 2,3,4. Serological H. pylori tests have a low positive
predictive value and result in false positive tests, which can lead to unnecessary testing,
antibiotic use, and repeat patient visits. The American Society for Clinical Pathology’s
“Choosing Wisely” recommendation also lists serology for H. pylori as a test to avoid
because it “is no longer considered clinically useful”5. Northern Light Laboratory
encourages the adoption of these evidence-based guidelines and believes that our
clients will benefit from phase out of this outdated testing methodology. Further
information can be found via the references below.

If you have any questions, please contact Microbiology at 207-973-6980 or Dr. Sarah Buss, Microbiology Director at 207-973-6971.

References:
1. https://www.aruplab.com/infectious-disease/h-pylori
2. AGA Board, American Gastroenterological Association Medical Position Statement: Evaluation of Dyspepsia, Nov 2005, page 1754.
3. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Chey, WD; Leontiadis, G; Howden, CW; Moss, SF MD. American Journal of Gastroenterology: February 2017 - Volume 112 - Issue 2 - p 212–239.
4. Am Fam Physician. 2018 Jan 15;97(2):135-137. H. pylori Infection: ACG Updates Treatment Recommendations. Randel A.
5. American Society for Clinical Pathology. Thirty Things Physicians and Patients Should Question. #14 Released September 14, 2016 (11-15). https://www.choosingwisely.org/societies/american-society-for-clinical-pathology/