What is the main test used to detect Helicobacter pylori infection?

The urea breath test is considered the main non-invasive test for detecting Helicobacter pylori infection. This test measures the production of carbon dioxide when a patient ingests a solution containing urea that has been labeled with a non-radioactive isotope, usually carbon-13. If H. pylori is present in the stomach, it breaks down the urea into ammonia and carbon dioxide, leading to an increased level of the labeled carbon dioxide in the breath, which can be detected and measured.

This method is preferred for its accuracy, ease of use, and patient comfort, as it does not require invasive procedures. Although the stool antigen test is also commonly used and can effectively diagnose an H. pylori infection, the urea breath test is often viewed as a more definitive method for active infections due to its straightforward interpretation and minimal patient discomfort.

Endoscopic biopsy and serological testing are useful in certain situations but are not typically the main tests for diagnosing H. pylori infections. An endoscopy requires sedation and is invasive, while serological testing can identify antibodies to H. pylori but may not accurately reflect an active infection. Therefore, the urea breath test stands out as the primary method for detecting H. pylori.