Gastric juice analysis in clinical practice: are we ready for the prime time?

Helicobacter pylori (H. pylori) infection is the main cause of the most frequent gastroduodenal diseases and gastric atrophy, with or without intestinal metaplasia, which predisposes to gastric cancer development. Gastric juice analysis may be useful in diagnosing these conditions, revealing the H. pylori infection and hypochlorhydria status by measuring ammonium concentrations and pH levels. EndoFaster is a device introduced to perform these analyses on gastric juice in real-time. The available data showed very high negative predictive values in ruling out the infection and corpus atrophic gastritis, thereby potentially reducing the need for gastric biopsies when test results are negative. This review aims to assess the potential role of EndoFaster in supporting the diagnosis of H. pylori infection, detecting gastric precancerous lesions, and other specific clinical applications, potentially reducing unnecessary gastric biopsies.