Endoscopy 2019; 51(04): S253-S254
DOI: 10.1055/s-0039-1681935
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Stomach and small intestine ePosters
Georg Thieme Verlag KG Stuttgart · New York

DIAGNOSTIC OF HELICOBACTER PYLORI VIA ENDOSCOPY: THE CLINICAL ISSUE OF SUPPRESSIVE CONDITIONS

RF Knoop
1   Gastroenterology and GI Oncology, University Medical Center, Göttingen, Germany
,
V Ellenrieder
1   Gastroenterology and GI Oncology, University Medical Center, Göttingen, Germany
,
A Neesse
1   Gastroenterology and GI Oncology, University Medical Center, Göttingen, Germany
,
S Kunsch
1   Gastroenterology and GI Oncology, University Medical Center, Göttingen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Testing for Helicobacter pylori (H. p.) is frequently conducted during esophagogastroduodenoscopy (EGD). Proton-pump inhibitors (PPI), upper gastrointestinal bleedings and recent antibiotic treatment deteriorate H. p. test quality.

Aim of our study was to evaluate the pattern of H. p. suppressive conditions in patients undergoing elective EGD in a large German university hospital.

Methods:

The survey was performed as a single center study in outpatients as well as inpatients. Over 6 months, every elective EGD was included and suppressive conditions were assessed. If H. p. testing was indicated according to guidelines, always both histology and rapid urease test (RUT) were conducted in analogy to the Sydney classification.

Results:

1631 patients were included (median 61 years, 36,0% outpatients, 64,0% inpatients). Overall, 76,5% were under H. p. suppressive conditions. Major suppressive condition was the intake of PPI (70,7%). 50,2% of all patients were tested. 82,7% were negative for both tests. Of those, 70,0% were tested under suppressive conditions with a high risk of false negative results. 17,3% had a positive H. p. testing. Here, only 9,9% showed an incongruent result (14,3% positive for RUT only and 85,7% positive for histology only). These discrepancies only occurred under suppressive conditions.

Conclusions:

Obviously, guidelines unanimously recommend H. p. testing under non-suppressive conditions. However, this often does not meet the clinical requirements. Especially, the demanded withdrawal of proton-pump inhibitors can often not be realized.

Our data represent the real clinical circumstances of testing in patients undergoing EGD with more than 60% of outpatients and even more than 80% of inpatients showing suppressive conditions leading to potentially more false negative results. In this respect, the present guidelines might not be expedient enough. Further research is needed to improve and clarify everyday clinical practice.