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What is Most sensitive non invasive test for diagnosis of H pylori? and explain in detail?
ELISA test has sensitivity of 80% and has been replaced by C-13 urea breath test and fecal antigen immunoassay. Both have sensitivity of >90%. Hence though rapid urease test is having a comparable sensitivity and higher specificity, it is an invasive test. Sensitivity of various diagnosis tests Test Sensitivity in % Rapid urease (INVASIVE) 80-95 Histology 80-90 Serology >80 Urea breath test (NON INVASIVE) >90 Stool antigen >90 In assessment of response to treatment, non-invasive tests are preferred. Breath urea test will be done but can be false negative if done within 4 weeks of antibiotic treatment. High levels of interleukin 1,2,6 & 8 and TNFa,IFN gamma in the gastric epithelium are found.