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[14C]-urea breath test to confirm eradication of Helicobacter pylori.
J Gastroenterol Hepatol 1999; 14(4):309-12JG

Abstract

BACKGROUND

Treatment for Helicobacter pylori reduces ulcer recurrence. Eradication rates of the organism vary with different drug regimens from 30% to 90%. There is a need to identify patients who have failed treatment. [14C]-Urea breath test (UBT) is non-invasive, sensitive, safe and highly reliable test for diagnosis of H. pylori infection. As there is a paucity of reports on the utility of [14C]-UBT in confirming H. pylori eradication, this study was undertaken.

METHODS

Thirty-eight patients (age 34 +/- 17 years, range 16-84 years, 27 men) with upper gastrointestinal symptoms underwent upper gastrointestinal endoscopy. Baseline H. pylori infection was diagnosed by identification of the organism on antral biopsies and positive rapid urease test (RUT). After 1 month of completion of treatment, repeat RUT and histological examination of antral endoscopic biopsies were performed. Eradication of H. pylori was defined as absence of the organism on histology, and negative RUT. The [14C]-UBT was performed using 185 kBq [14C]-urea dissolved in 300 mL water. Breath samples were collected once before ingestion of [14C]-urea, and subsequently at 5 and 15 min. Results were expressed as 14CO2/mmol CO2 exhaled as per cent of administered urea.

RESULTS

Endoscopy revealed antral gastritis (n = 14), duodenal ulcer (n = 8), duodenitis (n = 2), oesophagitis (n = 1), antral gastritis and duodenal ulcer (n = 3), antral gastritis and duodenitis (n = 7) and normal upper gastrointestinal endoscopy (n = 3). All the 20 patients who were negative for H. pylori on RUT and histology, tested negative for H. pylori on [14C]-UBT. However, of 18 patients shown to have H. pylori infection on RUT and histology, 16 were positive for H. pylori on [14C]-UBT. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of [14C]-UBT were 100, 89, 91, 100 and 95% respectively.

CONCLUSIONS

The [14C]-UBT is a reliable indicator of H. pylori eradication after treatment. It can obviate the need for antral biopsies to confirm eradication of H. pylori after completion of treatment.

Authors+Show Affiliations

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10207777

Citation

Sharma, B C., et al. "[14C]-urea Breath Test to Confirm Eradication of Helicobacter Pylori." Journal of Gastroenterology and Hepatology, vol. 14, no. 4, 1999, pp. 309-12.
Sharma BC, Bhasin DK, Pathak CM, et al. [14C]-urea breath test to confirm eradication of Helicobacter pylori. J Gastroenterol Hepatol. 1999;14(4):309-12.
Sharma, B. C., Bhasin, D. K., Pathak, C. M., Sinha, S. K., Ray, P., Vaiphei, K., & Singh, K. (1999). [14C]-urea breath test to confirm eradication of Helicobacter pylori. Journal of Gastroenterology and Hepatology, 14(4), pp. 309-12.
Sharma BC, et al. [14C]-urea Breath Test to Confirm Eradication of Helicobacter Pylori. J Gastroenterol Hepatol. 1999;14(4):309-12. PubMed PMID: 10207777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [14C]-urea breath test to confirm eradication of Helicobacter pylori. AU - Sharma,B C, AU - Bhasin,D K, AU - Pathak,C M, AU - Sinha,S K, AU - Ray,P, AU - Vaiphei,K, AU - Singh,K, PY - 1999/4/20/pubmed PY - 1999/4/20/medline PY - 1999/4/20/entrez SP - 309 EP - 12 JF - Journal of gastroenterology and hepatology JO - J. Gastroenterol. Hepatol. VL - 14 IS - 4 N2 - BACKGROUND: Treatment for Helicobacter pylori reduces ulcer recurrence. Eradication rates of the organism vary with different drug regimens from 30% to 90%. There is a need to identify patients who have failed treatment. [14C]-Urea breath test (UBT) is non-invasive, sensitive, safe and highly reliable test for diagnosis of H. pylori infection. As there is a paucity of reports on the utility of [14C]-UBT in confirming H. pylori eradication, this study was undertaken. METHODS: Thirty-eight patients (age 34 +/- 17 years, range 16-84 years, 27 men) with upper gastrointestinal symptoms underwent upper gastrointestinal endoscopy. Baseline H. pylori infection was diagnosed by identification of the organism on antral biopsies and positive rapid urease test (RUT). After 1 month of completion of treatment, repeat RUT and histological examination of antral endoscopic biopsies were performed. Eradication of H. pylori was defined as absence of the organism on histology, and negative RUT. The [14C]-UBT was performed using 185 kBq [14C]-urea dissolved in 300 mL water. Breath samples were collected once before ingestion of [14C]-urea, and subsequently at 5 and 15 min. Results were expressed as 14CO2/mmol CO2 exhaled as per cent of administered urea. RESULTS: Endoscopy revealed antral gastritis (n = 14), duodenal ulcer (n = 8), duodenitis (n = 2), oesophagitis (n = 1), antral gastritis and duodenal ulcer (n = 3), antral gastritis and duodenitis (n = 7) and normal upper gastrointestinal endoscopy (n = 3). All the 20 patients who were negative for H. pylori on RUT and histology, tested negative for H. pylori on [14C]-UBT. However, of 18 patients shown to have H. pylori infection on RUT and histology, 16 were positive for H. pylori on [14C]-UBT. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of [14C]-UBT were 100, 89, 91, 100 and 95% respectively. CONCLUSIONS: The [14C]-UBT is a reliable indicator of H. pylori eradication after treatment. It can obviate the need for antral biopsies to confirm eradication of H. pylori after completion of treatment. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/10207777/[14C]_urea_breath_test_to_confirm_eradication_of_Helicobacter_pylori_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0815-9319&date=1999&volume=14&issue=4&spage=309 DB - PRIME DP - Unbound Medicine ER -