Gastroscopy with biopsy of the gastric mucosa for rapid urease testing and histopathological examination remain the standard for diagnosis of Helicobacter pylori

Gastroscopy with biopsy of the gastric mucosa for rapid urease testing and histopathological examination remain the standard for diagnosis of Helicobacter pylori associated gastritis in daily clinical practice including in Thailand. Since the discovery of H. pylori in 1983, strong evidence has indicated that H. pylori infection plays an important role in the pathogenesis of chronic gastritis, gastric ulcer disease, gastric atrophy, intestinal metaplasia and gastric malignancy change (Komoto et al., 1998; Mihara et al., 1999). Although gastroscopic features of H. pylori associated gastritis have been reported in the literature, endoscopic diagnosis of H. pylori infection of the gastric mucosa by using conventional endoscopy and an Indigo carmine contrast method may be possible (Takahiro Kato et al., 2013). However are there the controversies about whether H. pylori associated gastritis that can be diagnosed by gastroscopic features alone. The Narrow Band Imaging system (NBI) is an endoscopic imaging technique for