Delta (13)C-urea breath test value is a useful indicator for Helicobacter pylori eradication in patients with functional dyspepsia.
BACKGROUND
Eradication of Helicobacter pylori is not routinely recommended for the symptomatic relief and the prevention of gastric cancer in patients with functional dyspepsia. The present study investigated a useful indicator of H. pylori eradication in such patients by determining the optimal cutoff value of a 13C-urea breath test (UBT).


METHODS
One hundred dyspeptic patients participated in the study. Dyspepsia was scored, and a 13C-UBT administered. A level of delta 13C-UBT of>4 per thousand was diagnosed as H. pylori-positive. After the stomach was endoscopically sprayed with phenol red, biopsy specimens were taken from the antrum, body and cardia of the stomach for the assessment of H. pylori density, and activity (neutrophil infiltration) and degree (lymphocyte infiltration) of gastritis.


RESULTS
Correlation between delta 13C-UBT and dyspepsia score was not found. Delta 13C-UBT significantly correlated with H. pylori density score in the total stomach (r = 0.53, P < 0.0001), neutrophil (r = 0.34, P = 0.0005) and lymphocyte score (r = 0.69, P < 0.0001). Twenty-six of the 100 subjects had a neutrophil score of >or=4, lymphocyte score of >or=4, and H. pylori score of >or=4. Their 95% confidence interval of mean was 58.2 per thousand, which reflects moderate to marked acute and chronic gastritis, and dense H. pylori colonization.


CONCLUSIONS
The 13C-UBT is a reliable semiquantitative test to assess H. pylori density and the activity and degree of gastritis. It is proposed that H. pylori eradication therapy might be beneficial for patients with functional dyspepsia with a delta 13C-UBT of >58.2 per thousand.
Chang
Young-Woon
YW
Department of Gastroenterology, Kyung Hee University College of Medicine, Seoul, South Korea. cywgi@chollian.net
Min
Sun-Kee
SK
Kim
Kyung-Jin
KJ
Han
Yo-Seob
YS
Lee
Joo-Hee
JH
Dong
Seok-Ho
SH
Kim
Hyo-Jong
HJ
Kim
Byung-Ho
BH
Lee
Joung-Il
JI
Chang
Rin
R
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001944:Breath Tests; D002250:Carbon Radioisotopes; D004415:Dyspepsia / Q000175:diagnosis* / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D007202:Indicators and Reagents; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D010637:Phenolsulfonphthalein; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013223:Statistics as Topic; D014508:Urea
D015415:Biomarkers; D002250:Carbon Radioisotopes; D007202:Indicators and Reagents; D019275:Radiopharmaceuticals; D014508:Urea; D010637:Phenolsulfonphthalein