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This review evaluates the clinical roles, limitations, and implementation maturity of established, molecular, and emerging diagnostic approaches.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>A narrative review was conducted using PubMed\/MEDLINE, Embase, Web of Science, the Cochrane Library, and Google Scholar, prioritizing clinical guidelines, systematic reviews, diagnostic accuracy studies, multicenter validation studies, and directly relevant method\u2010development research. Histology, rapid urease testing, and culture remain established biopsy\u2010based methods, whereas urea breath testing and validated monoclonal stool antigen testing are the leading non\u2010invasive options for detecting active infection and confirming eradication. Serology is useful only in selected settings because it cannot reliably distinguish current from previous infection. Culture provides phenotypic susceptibility results but is technically demanding. qPCR and targeted PCR provide faster, target\u2010specific genotypic information, while next\u2010generation sequencing may broaden resistance\u2010variant detection in specialist or surveillance settings. Genotypic findings require antibiotic\u2010specific interpretation because genotype\u2013phenotype concordance varies. AI\u2010assisted endoscopic interpretation, biosensors, LAMP, CRISPR\u2010based assays, and string test\u2010based sampling may address specific workflow gaps, but most remain adjunctive, selectively implemented, early translational, or investigational.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Diagnostic selection should begin with the clinical question and integrate patient risk, treatment history, medication exposure, local resistance patterns, specimen access, laboratory capacity, turnaround time, and available resources. Wider adoption of newer technologies requires external validation, standardization, quality assurance, regulatory readiness, economic assessment, and evidence that results improve clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70461","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:44:53Z","timestamp":1789033493000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Current\n                    <scp>\n                      <i>Helicobacter pylori<\/i>\n                    <\/scp>\n                    Diagnostics: Established Methods, Resistance Testing, and Emerging Approaches"],"prefix":"10.1002","volume":"10","author":[{"given":"Tianhua","family":"Tang","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University  Zhengzhou Henan 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