Urea breath test for Helicobacter pylori detection: present status. 2004

C M Pathak, and D K Bhasin, and K L Khanduja
Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India. Chander_Pathak@sify.com

Helicobacter pylori (H. pylori) is the commonest bacterial pathogen found worldwide and more than half the world population aged 40 years and above is colonized with it. The infection rate is >95 % in some African countries. In 1994, the International Agency for Research on cancer classified H. pylori as a class I carcinogen in humans. It causes chronic active gastritis, duodenal and gastric ulcer and gastric malignancy, and is thought to be associated with coronary artery disease, cerebral stroke, vitamin B12 and iron-deficiency anaemia, etc. Therefore, non-invasive test-and-treatment strategies are widely recommended in primary care settings. Conventionally, H. pylori infection can be diagnosed by invasive techniques using an upper gastrointestinal endoscope for obtaining multiple biopsies from different sites of the stomach for RUT, culture, histological examination, polymerase chain reaction (PCR), etc. and by non-invasive tests such as Urea breath test (UBT), stool antigen test and blood serology. At present, 13/14C-UBT is considered the test of choice for confirmation of H. pylori infection. The UBT is based on the principle, that isotopically labelled urea ingested by an H. pylori--infected patient is rapidly hydrolysed by the microbial urease. The released 13/14CO2 is absorbed across the mucous layer to the gastric mucosa and hence, excreted via the systemic circulation in the breath which is collected and measured. The non-hydrolysed urea is excreted completely in the urine within 3-4 days. 13C-UBT being non-radioactive, 13C-UBT can be used in pregnant women and children, and a user's license is not required. There is still no standard protocol accepted and followed internationally for this test. Although the methods are almost similar, various laboratories/clinics use variable tracer doses, test meals, timings and methods for breath collection, and different cut-off values, which make formal validation studies necessary. This review describes the present status of the UBT and its application in the detection of H. pylori infection.

UI MeSH Term Description Entries
D001944 Breath Tests Any tests done on exhaled air. Breathalyzer Tests,Breath Test,Breathalyzer Test,Test, Breath,Test, Breathalyzer,Tests, Breath,Tests, Breathalyzer
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014508 Urea A compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. Basodexan,Carbamide,Carmol
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D016480 Helicobacter pylori A spiral bacterium active as a human gastric pathogen. It is a gram-negative, urease-positive, curved or slightly spiral organism initially isolated in 1982 from patients with lesions of gastritis or peptic ulcers in Western Australia. Helicobacter pylori was originally classified in the genus CAMPYLOBACTER, but RNA sequencing, cellular fatty acid profiles, growth patterns, and other taxonomic characteristics indicate that the micro-organism should be included in the genus HELICOBACTER. It has been officially transferred to Helicobacter gen. nov. (see Int J Syst Bacteriol 1989 Oct;39(4):297-405). Campylobacter pylori,Campylobacter pylori subsp. pylori,Campylobacter pyloridis,Helicobacter nemestrinae
D016481 Helicobacter Infections Infections with organisms of the genus HELICOBACTER, particularly, in humans, HELICOBACTER PYLORI. The clinical manifestations are focused in the stomach, usually the gastric mucosa and antrum, and the upper duodenum. This infection plays a major role in the pathogenesis of type B gastritis and peptic ulcer disease. Infections, Helicobacter,Helicobacter Infection,Infection, Helicobacter

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