Biopsy tests (CLOtest, culture, histology) are done at endoscopy and are very accurate. They detect ACTUAL bacteria so they quickly become negative (24 hours or so) if Hp has been eradicated. However, drugs which inhibit Hp temporarily, such as antibiotics or Pepto-Bismol, may cause these tests to go negative. Just in case, back up a negative biopsy test with a serology - which should also be negative if Hp has never infected the patient. If the diagnosis of Hp is crucial to the patient's care, and the tests do not coincide, then one of them must be wrong!
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