14C-urea breath test in C pylori gastritis.
14C-urea breath test was used to detect Campylobacter pylori colonisation in 129 consecutive non-ulcer dyspepsia patients. Fasting patients were given 3 microCi (110 kBq) of 14C-labelled urea after a test meal. Breath samples were collected at 10 minute intervals for 90 minutes and the C-14 activity was counted on a liquid scintillation analyser. Urea derived 14CO2 appears in the exhaled breath of Campylobacter pylori culture positive individuals within 20-30 minutes. Likelihood analysis revealed a most favourable cut off level of [0.07% dose 14C-urea/mmol CO2] multiplied by body weight at t = 40 minutes, to separate culture positive from culture negative subjects. Using this upper limit of normal, a positive likelihood ratio of 50 and a negative likelihood ratio of 0.05 was calculated. Sensitivity of the test was 95% and specificity 98%. The 14C-urea breath test is a simple, sensitive and non-invasive test, that detects viable C pylori microorganism and semiquantitatively assesses the bacterial load of C pylori colonisation. Administration of a single dose of colloidal bismuth subcitrate resulted in a rapid decrease in 14CO2 excretion, so this test can be used to confirm eradication of the bacterium in therapeutic trials without endoscopy, or need for culture.
Rauws
E A
EA
Department of Gastroenterology-Hepatology, Academic Medical Center, University of Amsterdam, The Netherlands.
Royen
E A
EA
Langenberg
W
W
Woensel
J V
JV
Vrij
A A
AA
Tytgat
G N
GN
D001944:Breath Tests / Q000379:methods*; D002169:Campylobacter Infections / Q000175:diagnosis*; D002250:Carbon Radioisotopes; D005756:Gastritis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D014508:Urea
D002250:Carbon Radioisotopes; D014508:Urea