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Real-time EndoFaster improves Helicobacter pylori detection in chronic active gastritis
  1. Angelo Zullo1,
  2. Bastianello Germanà2,
  3. Ermenegildo Galliani2,
  4. Andrea Iori3,
  5. Giovanni De Pretis3,
  6. Guido Manfredi4,
  7. Elisabetta Buscarini4,
  8. Giovanni Guarnieri5,
  9. Renato Cannizzaro5,
  10. Matteo Rossano Buonocore6,
  11. Fabio Monica6
  1. 1 Gastroenterology and Digestive Endoscopy, Presidio Territoriale di Prossimità Nuovo Regina Margherita, Roma, Italy
  2. 2 Gastroenterology Unit, San Martino Hospital, Belluno, Italy
  3. 3 Gastroenterology and Digestive Endoscopy, Santa Chiara Hospital, Trento, Italy
  4. 4 Gastroenterology and Digestive Endoscopy, Maggiore Hospital Crema, Crema, Italy
  5. 5 Oncological Gastroenterology Unit, CRO, Aviano, Italy
  6. 6 Gastroenterology and Digestive Endoscopy, Ospedale di Cattinara, Trieste, Italy
  1. Correspondence to Dr Angelo Zullo, Presidio Territoriale di Prossimità Nuovo Regina Margherita, Roma, Italy; angelozullo66{at}


Helicobacter pylori is the most frequent cause of chronic active gastritis (CAG), namely the first step for gastric cancer development. When infection is not detected at histology, another test is advised. EndoFaster is novel device that reveal the presence of H. pylori by determining ammonium concentration in the gastric juice during endoscopy. We evaluated whether this test may improve etiological diagnosis in CAG patients. In 595 consecutive patients who underwent upper endoscopy gastric juice was analysed with EndoFaster and standard biopsies were taken. CAG with typical bacteria was detected in 102 (17.1%) patients, and CAG without H. pylori was found in 36 (6.3%) cases. EndoFaster detected the infection in 22 (61.1%) of these patients. Neither ongoing proton pump inhibitor therapy nor previous eradication therapy affect the test accuracy. By using EndoFaster, another test to search for the infection in H. pylori-negative CAG patients may be avoided in more than 60% of cases, impacting on both patients discomfort and health resources use.

  • gastritis
  • helicobacter
  • diagnostic techniques and procedures

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  • Handling editor Tony Mazzulli.

  • Contributors AZ and FM conceived the study, analysed data and prepared the manuscript. All the other authors enrolled patients and contributed with constructive criticisms. BG, EG, AI, GDP, GM, EB, GG, RC and MRB enrolled patients, performed endoscopy and collected data. All the authors participated with constructive criticisms and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.