Helicobacter pylori (H. pylori) is a gram-negative flagellated bacterium that inhabits the
gastric environment of 60.3% of the world population, and its prevalence is particularly high
in countries with inferior socioeconomic conditions, exceeding 80% in some regions of the
globe , This phenomenon occurs among other reasons, due to the unsatisfactory basic
sanitation and high people aggregations observed in many under developed nations, scenarios
that favour the oral-oral and fecal-oral transmissions of H.pylori.Another possible
transmission route of this pathogen is the sexual route.
Several studies have shown that the colonization of H.pylori could be negatively and
positively associated with the induction and progression of several diseases .It has been
reported to be linked to gastric and duodenal ulcer, gastric carcinoma, and gastric
mucosa-associated lymphoid tissue (MALT) lymphoma and gastritis ,A positive association also
reported between H.pylori infection and oesophageal cancer.
Moreover, evidence is also available on the positive association between H.pylori and non
gastrointestinal diseases such as diabetes mellitus , coronary artery disease
, and anaemia. Abdominal pain and discomfort, nausea, burping, and loss of appetite are
common symptoms of H.pylori infection. Other symptoms include, bloating, weight loss, and
heart burn.
Several approaches are used in the detection of H. pylori. Both the invasive and the
non-invasive methods are employed in the detection of H. pylori in a patient. Many factors,
however, influence choices in the method of diagnosis: availability of diagnostic
instruments/materials, sampling population, and competency and experience of the
physicians/clinicians .
Invasive methods include endoscopic evaluation, histology, rapid urease test (RUT), and
bacterial culture. Non-invasive methods include urea breath test (UBT), stool antigen test
(SAT), serology, and molecular diagnostic approaches .Endoscopy is an accurate test for
diagnosing the infection as well as the inflammation.
Endoscopy also allows the determination of the severity of gastritis with biopsies as well as
the presence of ulcers, MALT lymphoma and cancer.
Real-time endoscopy along with conventional white light imaging (WLI)and image enhanced
endoscopic (IEE)techniques, such as narrow-band imaging (NBI), linked color imaging (LCI) and
blue laser imaging (BLI), appear to have important roles in clinical practice to identify H.
pyloriinfected status .
Another endoscopic technique is i-scan digital chromoendoscopy, which is a digital contrast
method that enhances minute mucosal structures and subtle changes in color . The overall
diagnostic accuracy of i-scan is 97% compared to 78% for WLI .