Diagnosing Helicobacter pylori infection in vivo by novel endoscopic techniques

Abstract

Infection with Helicobacter pylori (H. pylori) is a worldwide problem. Endoscopic observation of H. pylori infection in vivo would be helpful to obtain an immediate diagnosis. The aim of this review is to describe recent advances in endoscopic technology and to review the available literature pertaining to its clinical application in H. pylori infection. Endoscopic visualization of H. pylori infection is not always feasible using conventional endoscopy. Thus, advanced endoscopic techniques have been developed with the aim of providing a precise and ‘‘real-time’’ endoscopic diagnosis. Recently, new endoscopic techniques such as magnifying endoscopy, narrow band imaging, I-Scan, endocytoscopy and endomicroscopy help focus examination of the stomach to diagnose disease in a time-efficient manner, and the analysis of mucosal surface details is beginning to resemble histologic examination. The new detailed images have enabled endoscopists to observe microscopic structures, such as gastric pit patterns, microvessels and cell morphology. Accordingly, endoscopic prediction of H. pylori infection is possible by analysis of surface architecture of the mucosa, which influences the clinical management. These endoscopic techniques might lead us to easier diagnosis and treatment of H. pylori-related diseases.

Keywords: Helicobacter pylori, Diagnosis, Gastrointestinal endoscopy

Core tip: Attempts to diagnose Helicobacter pylori (H. pylori) infection directly during endoscopy have been made in the past. With the aid of novel endoscopic techniques, it becomes easier to observe indirect and direct evidence of the presence of a H. pylori infection. Thus, the endoscopists can assess the abnormal mucosa in vivo and can generate smart biopsy samples rather than random biopsy samples.