**5. Diagnosis**

According to the American College of Gastroenterology (ACG), *H. pylori* testing is indicated in the following cases: [6].

All patients with active PUD


A complete history and physical examination are essential for identifying risk factors, symptoms, and signs associated with *H. pylori* infection [7]. These can include epigastric pain lasting for more than 4 weeks, or alarm symptoms like unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, abdominal pain, iron deficiency anemia (IDA), jaundice, gastrointestinal (GI) bleeding, and a family history of GI cancer. Following a thorough history and physical exam, appropriate diagnostic investigations should be recommended based on the assessment. There are a variety of invasive and non-invasive techniques to appropriately make the diagnosis of an *H. pylori* infection. Patients under age 55 and without alarm symptoms can be advised to go for noninvasive tests. Following are the different diagnostic investigations available in different clinical settings:

