Patients' attitudes to Helicobacter pylori breath and stool antigen tests compared to blood serology

Background: The National Institute for Health and Clinical Excellence (NICE) recommends that patients with uninvestigated dyspepsia, unresponsive to proton pump inhibitors, should be tested for Helicobacter pylori using a stool antigen or urea breath test rather than blood-based serology. Objective: To determine if a stool antigen or urea breath test is acceptable to patients. Method: Satisfaction questionnaire circulated to all primary care patients who had blood serology for H. pylori between January and July 2004. Results: Four hundred and sixty-two out of 717 Gloucestershire patients returned the questionnaire. Three-quarters of respondents stated that they would be willing to provide a stool or breath H. pylori test if they were told they were more accurate than the blood test. If the blood test was not available, 58% stated they would prefer the breath test and 34% the stool test. When patients were not given an explanation for the transfer to the new tests, only 11% stated they would prefer to provide a stool and 19% the breath test. 80% required an extra appointment for their blood test. Conclusion: The majority of patients would be happy to provide a stool sample or breath test provided they are made aware that these tests are more accurate than blood serology.