The investigative method of choice for confirmation of H.pylori eradication is
In summary, it is not necessary to perform endoscopy to diagnose H. pylori. Serology is the test of choice for initial diagnosis when endoscopy is not required. If, however, endoscopy is to be performed, the rapid urease assay and histology are both excellent options, but the cost advantage lies with the rapid urease assay. After treatment, the urea breath test is the method of choice but again should not be performed until 4 weeks after therapy ends. If the breath test is unavailable, endoscopy may be performed in selected patients such as those with bleeding ulcers or other complications of their PUD.
Urea breath test
Rapid urease assay
Culture from gastric mucosa
Serology