(13)C-urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese.
BACKGROUND
Conventional (13)C-urea breath testing ((13)C-UBT) includes a test meal to delay gastric emptying, which, theoretically, improves the accuracy of the test. Citric acid has been proposed as the best test meal. However, recent studies have suggested that a test meal may not be necessary.


OBJECTIVE
To investigate a new (13)C-UBT protocol without a test meal in a Chinese population.


METHODS
Consecutive dyspeptic patients referred for upper endoscopy were recruited. (13)C-UBT was performed on two separate days with or without a test meal (2.4 Gm citric acid) and compared with the 'gold standard' (CLO test and histology).


RESULTS
Two hundred and two patients were tested. Using receiver operating characteristics (ROC) analysis, the optimal delta-value and optimal measurement interval for UBT were 5% and 30 min, respectively, both with or without a test meal. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (13)C-UBT with citric acid (96.5%, 97.7%, 98.2%, 95.6%, 97.0%) were similar to (13)C-UBT without a test meal (94.7%, 97.7%, 98.2%, 93.5%, 96.0%).


CONCLUSIONS
This simplified (13)C-UBT protocol without a test meal produced highly accurate and reliable results in the Chinese population.
Wong
W M
WM
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Wong
B C
BC
Wong
K W
KW
Fung
F M
FM
Lai
K C
KC
Hu
W H
WH
Yuen
S T
ST
Leung
S Y
SY
Lau
G K
GK
Lai
C L
CL
Chan
C K
CK
Go
R
R
Lam
S K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001944:Breath Tests; D002681:China; D004415:Dyspepsia / Q000150:complications / Q000175:diagnosis; D005260:Female; D005502:Food; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000473:pathology; D013997:Time Factors; D014508:Urea / Q000032:analysis*
D014508:Urea