Role of Proton Pump Inhibitors on Rapid Urease Test (PYLO DRY) and Histopathological Examination

Abstract

In the diagnosis of Helicobacter pylori infection, rapid urease test (RUT) plays an important role. According to previous studies, if there was a low density of Helicobacter pylori in the stomach, then rapid urease test requires longer time to become positive. Density of Helicobacter pylori could be reduced by recent use of PPIs, hence rapid urease test may require longer reading time as well. The main objective was to determine the effect of PPI on the results of rapid urease test (PYLO DRY) and histopathology. Two antral biopsies were obtained from 35 dyspeptic patients, who underwent gastro intestinal endoscopy from March 2015 to July 2015. An informed consent from all patients and approval from the institutional ethical committee were obtained before proceeding. Antral biopsies were subjected for rapid urease test (PYLO DRY from HALIFAX RESEARCH LABORATORY KOLKATA, INDIA) and histopathologic examinations. The results of Rapid urease test were observed after 1 hour and 24 hours. The histopathologic examinations were used as the gold standard. PYLO DRY was positive in 17.6% (6) and 53 % (18) when observed after one hour and 24 hours respectively. Eight were positive during histopathological examination. In our study, 24 hours Rapid urease test yeilded higher sensitivity but lower specificity compared to RUT at 1 hour for diagnosis of H.pylori infection in patients who were on PPI.