What are the three testing modalities for Helicobacter pylori infection?

The most accurate set of testing modalities for Helicobacter pylori infection consists of the Urease Breath Test, the Serum Antibody Test, and EGD with Biopsy.

The Urease Breath Test is a non-invasive test that detects the presence of H. pylori by measuring the production of urease, an enzyme produced by the bacteria. This test is known for its high sensitivity and specificity and is commonly used due to its ease and effectiveness.

The Serum Antibody Test checks for antibodies against H. pylori in the bloodstream. While it can indicate past or present infection, it's important to note that this test may remain positive even after the infection has been eradicated, which can sometimes limit its use in determining current infection status.

EGD, or esophagogastroduodenoscopy, with biopsy allows for direct visualization of the gastric mucosa and the opportunity to take biopsies for histological examination. This approach not only confirms the presence of H. pylori but also allows the physician to investigate for other gastric pathologies.

This combination of tests provides a comprehensive approach to diagnosing H. pylori infection, balancing non-invasive and invasive methods, as well as acute and historical infection detection.