13C-urea breath test for the diagnosis of Helicobacter pylori infection before treatment: is citric acid necessary?

Gisbert, Javier P.; Vázquez, M.A.; Jiménez, Isabel; Cruzado, A.I.; Carpio, Daniel; Castillo, Enrique Del; Martín, María Jesús Álvarez; Morales, Alberto Jiménez; Pajares, R.; Rodriguez, Arnulfo; Jm, Pajares García

doi:10.1016/s1590-8658(00)80039-0

Cited by 19 publications

(20 citation statements)

References 7 publications

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“…However, median DOB values at 20 and 30 min for both protocols showed significant differences (P = 0.006 and P = 0.001, respectively). These results are in accordance with those by Atherton et al [113] H Van der Hulst [46] 1999 LARA H, C 544 NA 100 Powder in 50 mL sterile water and Gisbert et al [47] , who showed that the test meal did not affect 13 C-UBT results at 10 min, but increased the values thereafter.…”

supporting

confidence: 89%

“…From each study, the protocol with the best diagnostic performance was selected . Of these, 12 (30%) yielded sensitivities and specificities of 100% [33,37,43,45,47,56,61,63,65,[67][68][69] . Based on the results after reviewing the literature, the present study introduced several variations to simplify even further the technique and make it more cost-efficient, without compromising the high standards of sensitivity, specificity, positive and negative predictive values of the test.…”

Section: Discussionmentioning

confidence: 99%

“…Later on, doses of 125 [35,72] and 100 mg [36,40,47,48,51,54,57,60,62,65,[73][74][75][76][77][78][79][80][81][82][83] were validated by several American, European and Asian groups, and more recently 75 mg [32,37,[43][44][45]49,50,55,72,[84][85][86][87][88][89][90][91][92][93] , 50 mg [52,56,58,94,95] , 38 mg [96] , 25 mg and even 10 mg [69] of 13 C-urea have proved to be sufficient.…”

Section: Urea Dosementioning

confidence: 99%

“…As shown in Table 3, the majority of the test meals have provided reliable results. Even the complete absence of a test meal has shown little, if any, variation in the diagnostic performance of the assay [35,40,47,53,56,59,60,102,104] .…”

Section: Test Mealmentioning

confidence: 99%

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An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

Campuzano-Maya¹

2007

WJG

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AIM:To validate an optimized 13C-urea breath test ( 13 C-UBT) protocol for the diagnosis of H pylori infection that is cost-efficient and maintains excellent diagnostic accuracy. METHODS: 70 healthy volunteers were tested with two simplified 13 C-UBT protocols, with test meal (Protocol 2) and without test meal (Protocol 1). Breath samples were collected at 10, 20 and 30 min after ingestion of 50 mg 13 C-urea dissolved in 10 mL of water, taken as a single swallow, followed by 200 mL of water (pH 6.0) and a circular motion around the waistline to homogenize the urea solution. Performance of both protocols was analyzed at various cut-off values. Results were validated against the European protocol. RESULTS:According to the reference protocol, 65.7% individuals were positive for H pylori infection and 34.3% were negative. There were no significant differences in the ability of both protocols to correctly identify positive and negative H pylori individuals. However, only Protocol 1 with no test meal achieved accuracy, sensitivity, specificity, positive and negative predictive values of 100%. The highest values achieved by Protocol 2 were 98.57%, 97.83%, 100%, 100% and 100%, respectively. CONCLUSION:A 10 min, 50 mg 13 C-UBT with no test meal using a cut-off value of 2-2.5 is a highly accurate test for the diagnosis of H pylori infection at a reduced cost.

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supporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Urea Dosementioning

confidence: 99%

Section: Test Mealmentioning

confidence: 99%

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An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

Campuzano-Maya¹

2007

WJG

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“…Different nutrient meals have been used, including mixtures of carbohydrates, proteins and fats, with quite similar results 6, 7, 11, 14 . A citric acid solution is currently one of the most widely used, and it has been stated that, thanks to its use, higher and faster maximum concentrations of 13 CO 2 are obtained in the breath in comparison with other semiliquid test meals previously used 45, 88–93 . Consequently, a citric acid test meal may increase the discrimination between positive and negative UBT values.…”

Section: Is a Test Meal Necessary? Which Test Meal Is Better?mentioning

confidence: 99%

Review article: ¹³C‐urea breath test in the diagnosis of Helicobacter pylori infection – a critical review

Gisbert

2004

Aliment Pharmacol Ther

321

281

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SUMMARYThe urea breath test is a non-invasive, simple and safe test which provides excellent accuracy both for the initial diagnosis of Helicobacter pylori infection and for the confirmation of its eradication after treatment. Some studies have found no differences between urea breath test performed under non-fasting conditions. The simplicity, good tolerance and economy of the citric acid test meal probably make its systematic use advisable. The urea breath test protocol may be performed with relatively low doses (<100 mg) of urea: 75 mg or even 50 mg seem to be sufficient. With the most widely used protocol (with citric acid and 75 mg of urea), excellent accuracy is obtained when breath samples are collected as early as 10-15 min after urea ingestion. A unique and generally proposed cut-off level is not possible because it has to be adapted to different factors, such as the test meal, the dose and type of urea, or the pre-/post-treatment setting. Fortunately, because positive and negative urea breath test results tend to cluster outside of the range between 2 and 5&, a change in cut-off value within this range would be expected to have little effect on clinical accuracy of the test.

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

Best

Takwoingi

Siddique

et al. 2018

Cochrane Database of Systematic Reviews

153

130

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In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions.

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13C-urea breath test for the diagnosis of Helicobacter pylori infection before treatment: is citric acid necessary?

Cited by 19 publications

References 7 publications

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

Review article: ¹³C‐urea breath test in the diagnosis of Helicobacter pylori infection – a critical review

Non-invasive diagnostic tests forHelicobacter pyloriinfection

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13C-urea breath test for the diagnosis of Helicobacter pylori infection before treatment: is citric acid necessary?

Cited by 19 publications

References 7 publications

An optimized13C-urea breath test for the diagnosis ofH pyloriinfection

An optimized13C-urea breath test for the diagnosis ofH pyloriinfection

Review article: 13C‐urea breath test in the diagnosis of Helicobacter pylori infection – a critical review

Non-invasive diagnostic tests forHelicobacter pyloriinfection

Contact Info

Product

Resources

About

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

Review article: ¹³C‐urea breath test in the diagnosis of Helicobacter pylori infection – a critical review