Pre-endoscopy screening of Helicobacter pylori infection: implication and advantages

Different invasive and non-invasive diagnostic tests are available for the diagnosis of Hp in the individual patient. The non-invasive tests obviate the need for endoscopy and can be surely more accepted by the subjects. Moreover the endoscopy has a high cost and provides a marked workload and medical expenses for the hospitals . So the strategy followed by the gastroenterologists but more specifically in general practice is to avoid the endoscopy in patients at low risk of having major pathology. These patients could prevent prompt endoscopy and might safely undergo different managements. It has been proposed [22 23 26] that younger patients with symptoms of dyspepsia with non alarming symptoms could be screened non-invasively for the infection in order to reduce endoscopy procedure. In addition, non-invasive tests are suitable, other than for pre-endoscopy screening of younger dyspeptics, also for use in research and for epidemiological surveys as well as for confirming successful eradication after treatment and for screening asymptomatic population. The pre-endoscopy screening is based on different methodologies (such as serological markers, molecular markers, etc.) that will be discussed in the present