title: The use of a second biopsy from the gastric body for the detection of Helicobacter pylori using rapid urease test.
abstract: BACKGROUND
  The use of an additional biopsy from the gastric body may help improve the detection of Helicobacter pylori during endoscopy. This study aimed to determine whether such an additional biopsy is necessary in routine rapid urease test (RUT), and whether acid suppression and antibiotic therapy affect RUT results.
  
  
  METHODS
  Patients recruited had two gastric mucosal biopsies taken - one from the gastric antrum and the other from the gastric body. Each biopsy was placed into separate RUT kits. Information on previous or current use of proton-pump inhibitors, H2 receptor antagonist, bismuth and antibiotics was obtained. Patients on any of those drugs one week prior to endoscopy were considered to have a positive drug history (PDH).
  
  
  RESULTS
  Of the 400 patients recruited, 311 had negative RUTs and 89 had at least one positive RUT. Between the PDH and negative drug history (NDH) groups, there was a significant difference in the distribution of the location of the biopsies that yielded positive RUTs (p = 0.023). The NDH group had a higher proportion of patients who had positive RUTs for both locations, whereas the PDH group had a higher proportion of patients who had positive RUTs for only one location.
  
  
  CONCLUSIONS
  As RUT results are significantly affected by the use of acid suppression and antibiotic therapies, biopsies for RUT should be taken from both the gastric antrum and body to minimise false negative results.
authors: Department of Surgery, Changi General Hospital, 2 Simei Street 3, Singapore 529889. andrew_wong@cgh.com.sg.
authors: Andrew
authors: A
authors: Wong
authors: Siok Siong
authors: SS
authors: Ching
authors: Ai Sha
authors: AS
authors: Long
mesh_terms: D000328:Adult; D000368:Aged; D000863:Antacids / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D004724:Endoscopy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification*; D049690:History, Ancient; D006801:Humans; D008875:Middle Aged; D012846:Singapore / Q000453:epidemiology; D014510:Urease / Q000032:analysis*
chemical_list: D000863:Antacids; D000900:Anti-Bacterial Agents; D014510:Urease
references: Aliment Pharmacol Ther. 1999 Oct;13(10):1287-93
references: 10540042
references: Gastroenterol Clin North Am. 2000 Dec;29(4):871-8
references: 11190071
references: Eur J Gastroenterol Hepatol. 2001 Apr;13(4):387-90
references: 11338067
references: Hepatogastroenterology. 2002 Mar-Apr;49(44):572-5
references: 11995500
references: World J Gastroenterol. 2006 Sep 28;12(36):5757-62
references: 17007038
references: Am J Gastroenterol. 2007 Aug;102(8):1808-25
references: 17608775
references: World J Gastroenterol. 2008 Jun 28;14(24):3855-60
references: 18609709
references: J Gastroenterol Hepatol. 2009 Oct;24(10):1587-600
references: 19788600
references: Gut. 2012 May;61(5):646-64
references: 22491499
references: Clin Endosc. 2012 Nov;45(4):392-6
references: 23251887
references: BMC Gastroenterol. 2012 Dec 29;12:182
references: 23272897
references: Med J Armed Forces India. 2003 Jul;59(3):216-7
references: 27407519
references: Lancet. 1984 Jun 16;1(8390):1311-5
references: 6145023
references: Med Clin (Barc). 1995 Nov 4;105(15):566-9
references: 7500675
references: Gastrointest Endosc. 1994 May-Jun;40(3):342-5
references: 7794303
references: Gut. 1995 Jan;36(1):12-6
references: 7890214
references: Lancet. 1993 Sep 4;342(8871):575-7
references: 8102719
references: Aliment Pharmacol Ther. 1996 Apr;10 Suppl 1:57-64
references: 8730260
references: Am J Gastroenterol. 1996 Oct;91(10):2120-4
references: 8855733
references: Gastrointest Endosc. 1996 Nov;44(5):523-6
references: 8934155
references: Aliment Pharmacol Ther. 1997 Feb;11(1):109-12
references: 9042982
references: Am J Gastroenterol. 1997 Aug;92(8):1310-5
references: 9260796
references: Helicobacter. 1996 Dec;1(4):256-9
references: 9398877
references: Ann Acad Med Singapore. 1997 Sep;26(5):637-41
references: 9494671