Non-invasive testing usually preferred:
- H. pylori stool antigen (use a dry sterile container)
- Urea breath test
In patients undergoing endoscopy for dyspepsia, gastric biopsy urease testing can be used as well.
To prevent false negatives, prior to testing: stop antibiotics, bismuth, and PPI for at least 4 weeks. H2 receptor antagonists (H2RAs) and antacids should be stopped for at least 24 hours.
DO NOT use serologic testing, as it cannot differentiate between active or prior infection