Tests Offer Early Detection of Gastric Disorders

Two new diagnostic tests, GastroPanel and GastroView, when used as routine examinations in health screening as well as in the diagnosis of dyspepsia, Helicobacter pylori infection, and atrophic gastritis, can make it possible to improve the early diagnosis of the most important risk factor for gastric cancer, namely, mildly symptomatic and in most cases asymptomatic atrophic gastritis.

The tests also improve on patient safety. Utilization of these new developments can reduce the number of unnecessary procedures (gastroscopies) and treatments (continuous reduction of gastric acid secretion with protein pump inhibitor [PPI] therapy and/or unnecessary eradication therapy for H. pylori).

Both GastroPanel and GastroView tests were developed by Biohit (Helsinki, Finland). At the beginning of the 1980s, Australian researchers discovered that inflammation in the stomach (gastritis) as well as ulceration of stomach or duodenum (peptic ulcer disease) are the result of H. pylori infection in the stomach.

The unique, non-invasive GastroPanel examination diagnoses not only H. pylori infection, but also atrophic gastritis and its location. Atrophic gastritis causes an increase risk of gastric cancer, vitamin B12 deficiency, and peptic ulcer disease. GastroPanel also reveals if the risk of gastroesophageal reflux disease is increased, due to high stomach acid secretion. The test measures four biomarkers in blood: pepsinogen I and II, gastrin-17, and H. pylori antibodies. The GastroPanel examination and the GastroSoft software interpreting its results have been developed for use as a primary and follow-up examination in the diagnosis and treatment of patients with dyspepsia, H. pylori infection, atrophic gastritis, and related risks.

If the GastroPanel examination gives a normal result, the diagnosis is either functional dyspepsia or another disease not involving the gastric mucosa. The examination diagnoses H. pylori infection, atrophic gastritis, and its location (corpus, antrum, or both). GastroSoft interpretation software shows the test results, reference ranges, and diagnosis, and when necessary gives recommendation on possible treatment or further testing. The GastroSoft report also indicates if there is an increased risk of gastroesophageal reflux disease.

Until now, before the GastroPanel test was invented, H. pylori-related atrophic gastritis and the associated risks could only be detected with gastroscopy and biopsy specimen examination. The current "test-and-treat” method is unable to detect the disorder. This serious medical and ethical problem can be corrected simply and economically by including the GastroPanel examination as the test used in the test-and-treat strategy.

The GastroPanel test will allow practical medicine to benefit from the discovery of H. pylori even more than before, according to Biohit researchers. When combined, the two newly developed tests should promote the development of safe and ethical evidence-based therapy, particularly in outpatient care and possibly also in screening examinations.

Serologic tests that measures specific H. pylori IgG and IgA antibodies can determine if an individual has been infected and has been a commonly used test for several years. This has normally only been available from a venous blood sample (syringe sampling from a vein) taken at a hospital or a doctor's office. Biohit have now combined this test with two other extremely useful markers, pepsinogen I and pepsinogen II, in the patented Gastroview concept that is available through a single finger-prick blood sample.

Prolonged infection with H. pylori can cause a number of problems, including peptic ulcers, and changes to the gastric mucosa and atrophic gastritis, in particular. In a process of chronic gastritis of the stomach mucosa, gastric glandular cells are lost and eventually replaced by intestinal and fibrous tissues. As a result, the stomach's secretion of essential substances such as hydrochloric acid, pepsinogens, and intrinsic factor is impaired, leading to digestive problems, vitamin B12 deficiency, and megaloblastic anemia. Vitamin B12 deficiency has also been associated with dementia. This cascade effect can lead to very serious long-term implications.

The concentrations of these markers and the presence or absence of H. pylori will provide a health check on the stomach and all from a finger-prick blood sample. In addition to asymptomatic atrophic gastritis, the GastroView test also detects gastroesophageal reflux disease (GERD). Approximately one-fourth of the population suffers from this condition that puts the patient at risk of severe complications including erosive esophagitis and so-called Barrett's esophagus, which can be asymptomatic and over time, unless treated, can even progress into esophageal cancer.

The test results are provided in a comprehensive report that can be given to the individual's doctor if necessary, but in non-technical language, the combination of results from the markers tested (H. pylori, pepsinogen I, and pepsinogen II) will give a good indication of the level of atrophic gastritis in the gastric mucosa (if any). The results will also be provided with recommendations.

Scientists at Biohit recommend that the GastroPanel and GastroView examinations be used as a routine screening examination for all patients over 45, and included in the treatment practice of dyspepsia-like complaints in patients of all ages. To ensure patient safety, a GastroPanel examination or a gastroscopy is recommended before any PPI therapy and H. pylori eradication therapy. Unlike gastroscopy, GastroPanel is able to assess the recovery of the loss of the function of gastric mucosa due to atrophic gastritis and the risk of complications from GERD.

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