title: A 20-minute breath test for helicobacter pylori.
abstract: In this study, we evaluated a simplified rapid 14C-urea breath test for the diagnosis of Helicobacter pylori. Fasting patients undergoing initial assessment for H. pylori drank 5 microCi of 14C-urea in 20 ml of water. Breath was collected at intervals for 30 min. Samples were counted in a beta-counter, and the results were expressed as counts per minute (cpm). In the same week, patients underwent endoscopy, and a blinded investigator examined biopsy samples of gastric mucosa by culture and histology for H. pylori. There were 49 H. pylori-negative (HP-) and 104 H. pylori-positive (HP+) patients in the study. HP+ patients expired a mean of 4398 cpm (SD 2468) per mmol CO2 in a sample taken 20 min after ingestion of the isotope. In contrast, HP--patients expired only 340 cpm (SD 196). If the mean +3 SD of HP- patients was used as a cutoff value, the 20-minute sample gave a sensitivity of 97% and a specificity of 100% for detecting H. pylori. The radiation exposure from this test is less than 1% of that received from an upper gastrointestinal series, and the short collection time makes it both convenient and cost effective.
authors.affiliation: Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville.
authors.forename: B J
authors.initials: BJ
authors.lastname: Marshall
authors.forename: M W
authors.initials: MW
authors.lastname: Plankey
authors.forename: S R
authors.initials: SR
authors.lastname: Hoffman
authors.forename: C L
authors.initials: CL
authors.lastname: Boyd
authors.forename: K R
authors.initials: KR
authors.lastname: Dye
authors.forename: H F
authors.initials: HF
authors.lastname: Frierson
authors.forename: R L
authors.initials: RL
authors.lastname: Guerrant
authors.forename: R W
authors.initials: RW
authors.lastname: McCallum
mesh_terms: D001706:Biopsy; D001830:Body Surface Area; D001944:Breath Tests / Q000379:methods*; D002250:Carbon Radioisotopes; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D006207:Half-Life; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013997:Time Factors; D014508:Urea
chemical_list: D002250:Carbon Radioisotopes; D014508:Urea