Abstract
H. pylori is a potent urease producer, a characteristic that has been exploited in the development of the[14C]- and [13C]urea breath tests. The prevalence of H. pylori infection also is known to increase with advancing age; however, the individual patient's age has not routinely been considered when interpreting urea breath test results. The aim of this study was to validate a short, age-adjusted [14C] urea breath test for use in diagnosing H. pylori infections. Forty-one subjects (28 volunteers, 13 patients) underwent esophagogastroduodenoscopy with biopsies. Subjects were defined as being H. pylori positive if histology or culture was positive. In addition, all subjects completed a 120-min [14C]urea breath test. A logistic regression analysis adjusting for age was used to estimate the probability of H. pylori positivity as a function of the14C values generated. Sixteen subjects were H. pylori-positive, and 25 were H. pylori negative. The14C values generated between 15 and 80 min were found to be equally predictive in identifying H. pylori-positive subjects. Advancing age was associated with a higher probability of H. pylori positivity. By taking advantage of the statistical probabilities, older patients could be accurately diagnosed with H. pylori at lower14C values. We found that [14C]urea breath test to be both a sensitive and specific test that can be abbreviated to a 30-min examination (total test time). Moreover, our mathematical model indicates that a patient's age should be considered in order to optimize interpretation of the [14C]urea breath test, although further observations are needed to confirm this model.
Similar content being viewed by others
References
Marshall BJ, McGechie DB, Roger PA, Glancy RJ: Pyloric campylobacter infection and gastroduodenal disease. Med J Aust 142:439–444, 1985
Ormand JE, Talley NJ:Helicobacter pylori: Controversies and an approach to management. Mayo Clin Proc 65:414–426, 1990
Goodwin CS, Armstrong JA, Marshall BJ:Campylobacter pyloridis, gastritis, and peptic ulceration. J Clin Pathol 39:353–365, 1986
Hazell SL, Lee A:Campylobacter pyloridis, urease, hydrogen ion back diffusion, and gastric ulcers. Lancet 2:15–17, 1986
Fromm H, Hofmann AF: Breath test for altered bile acid metabolism. Lancet 2:621–625, 1971
Graham DV, Klein PD, Evans DJ, Evans DG, Alpert LC, Opekun AR, Boutton TW:Campylobacter pylori detected noninvasively by the13C-urea breath test. Lancet 1:1174–1177, 1987
Marshall BJ, Surveyor I: Carbon-14-urea breath test for the diagnosis ofCampylobacter pylori associated gastritis. J Nucl Med 29:11–16, 1988
Bell GD, Weil J, Harrison G, Morden A, Jones PH, Gant PW, Trowell JE, Yoong AK, Daneshmend TK, Logan RFA:14C-urea breath analysis, a non-invasive test forCampylobacter pylori in the stomach. Lancet 1:1367–1368, 1987
Marshall BJ, Guerrant RL, Plankey MW, Dye KR, Barrett L, Frierson HF, Hoffman SR, McCallum RW: Comparison of14C-urea breath test, microbiology and histology for the diagnosis ofCampylobacter pylori. Gastroenterology 94:A284, 1988
Veldhuyzen van Zanten S, Tytgat K, Hollingsworth J, Jalali S, Rashid FA, Bowen BM, Goldie J, Goodacre RL, Riddell RH, Hunt RH:14C-urea breath test for the detection ofHelicobacter pylori. Am J Gastro 85:399–403, 1990
Rauws EAJ, Royen EAV, Langenberg W, Woensel JV, Vrij AA, Tytgat GN: C14-urea breath test inC. pylori gastritis. Gut 30:798–803, 1989
Lambert JR, Yeomans ND:Campylobacter pylori-gastroduodenal pathogen or opportunistic bystander? Aust NZ J Med 18:555–556, 1988
Hornick RB: Peptic ulcer disease: A bacterial infection? N Engl J Med 316:1598–1600, 1987
Dooley CP, Cohen H, Fitzgibbons LP, Bauer M, Appleman MD, P-Perez GI, Blaser MJ: Prevalence ofHelicobacter pylori and histologic gastritis in asymptomatic persons. N Engl J Med 321:1562–1566, 1989
Jones DM, Eldridge J, Fox AJ, Sethi P, Whorwell PJ: Antibody to the gastric campylobacter-like organism (“Campylobacter pyloridis”)—clinical correlations and distribution in the normal population. J Med Microbiol 22:57–62, 1986
Morris A, Nicholson G, Lloyd G, Haines D, Rogers A, Taylor D: Seroepidemiology ofCampylobacter pyloridis. NZ Med J 99:657–659, 1986
Author information
Authors and Affiliations
Additional information
Supported in part by grant DK34988 from the National Institutes of Health, U.S. Public Health Service.
Rights and permissions
About this article
Cite this article
Ormand, J.E., Talley, N.J., Carpenter, H.A. et al. [14C]urea breath test for diagnosis ofHelicobacter pylori . Digest Dis Sci 35, 879–884 (1990). https://doi.org/10.1007/BF01536802
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01536802