Effect of Proton Pump Inhibitors and Antacid Therapy on 13C Urea Breath Tests and Stool Test for Helicobacter Pylori Infection

Gatta, Luigi; Vakil, Nimish; Ricci, Chiara; Osborn, John; Tampieri, Andrea; Perna, Federico; Miglioli, M.; Vaira, Dino

doi:10.1111/j.1572-0241.2004.30162.x

Cited by 118 publications

(101 citation statements)

References 25 publications

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“…Moreover, we should understand the factors that can lead to a false-positive or falsenegative. Administration of antibiotics or antacid agents within 2 -4 weeks of testing may result in a false-negative in all tests except for antibody examination [9] [10] [11]. In addition, the accuracy of UBT and antibody tests may be influenced by the age of the tested child [12].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

Ikuse¹,

Kudo²,

Obayashi³

et al. 2017

AiM

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Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H. pylori) and prevent gastric cancer. Our aim was to assess the performance of non-invasive tests to diagnose H. pylori infection in pediatric patients. A retrospective analysis was performed on 141 pediatric patients requiring endoscopic evaluation and diagnostic tests for H. pylori infection to define the cause of abdominal symptoms. Non-invasive tests included the 13 C-urea breath test (UBT), a monoclonal stool antigen test using enzymelinked immuno-sorbent assay (mSAT), and a serum immunoglobulin G antibody test using antigens derived from Japanese individuals (S-Ab). This study investigated sensitivity, specificity, likelihood ratios for a positive and a negative test (LR + and LR − ), and accuracy of non-invasive tests, in comparison with invasive tests. Eighty two of 141 patients (58%) were recognized as H. pylori positive by invasive methods. When UBT, mSAT or S-Ab were analyzed, all were found to be effective over 94% accurate. Specificity ranged between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When subjects were stratified into three distinct age groups, the best performance was achieved for 1 -6 years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab yielded the best results for children 7 -12 years old and the UBT test performed best for 13 -18 years old. These results demonstrate the utility of UBT, mSAT, and S-Ab non-invasive tests in diagnosing H. pylori but suggest that certain tests may be optimal for children of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining with a histological test and a culture test in children.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

Ikuse¹,

Kudo²,

Obayashi³

et al. 2017

AiM

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“…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%

“…Through the years there have been numerous modifications to the test meal, including the use of citric acid alone before administering the urea [37,62,67,79,84,85,97] , or mixed with the 13 C-urea at the time of administration [43][44][45]88,91,98] , or as a presentation in combination with the 13 C-urea [42,61,72,94,99] . Several alternatives to citric acid have also been tested, including orange juice [43,49,67,90,95] and apple juice [100] , as well as other types of food such as milk [48,58,101,102] and a pudding test meal [34,46] , and even water [41,103] . As shown in Table 3, the majority of the test meals have provided reliable results.…”

Section: Test Mealmentioning

confidence: 99%

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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“…Cost-effectiveness studies suggest that the choice of a noninvasive test should also be based on the prevalence of infection in the community. In low-and intermediate-prevalence situations, the stool antigen test or the urea breath test are favored [Vakil et al 2000] but to ensure accuracy, these tests should only be done when the patient has been off PPIs for at least 2 weeks [Gatta et al 2004;Malfertheiner et al 2002]. The accuracy of H. pylori serology has been questioned, especially in low prevalence areas such as many parts of North America.…”

Section: Helicobacter Pylorimentioning

confidence: 99%

Review: Evaluation and management of dyspepsia

Harmon

Peura

2010

Therap Adv Gastroenterol

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Dyspepsia is a common clinical problem seen by both primary care physicians and gastroenterologists. Initial evaluation should focus on the identification and treatment of potential causes of symptoms such as gastroesophageal reflux disease (GERD), peptic ulcer disease, and medication side effects but also on recognizing those at risk for more serious conditions such as gastric cancer. This manuscript discusses the evaluation and management of dyspepsia including the role of proton-pump inhibitors, treatment of Helicobacter pylori, and endoscopy. Finally, treatment of refractory functional dyspepsia is addressed.

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Effect of Proton Pump Inhibitors and Antacid Therapy on 13C Urea Breath Tests and Stool Test for Helicobacter Pylori Infection

Abstract: False negative breath and stool tests are equally common in patients taking proton pump inhibitors. Antacids do not impair the sensitivity of the breath tests or the stool test.

Cited by 118 publications

References 25 publications

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection

Review: Evaluation and management of dyspepsia

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Effect of Proton Pump Inhibitors and Antacid Therapy on 13C Urea Breath Tests and Stool Test for Helicobacter Pylori Infection

Abstract: False negative breath and stool tests are equally common in patients taking proton pump inhibitors. Antacids do not impair the sensitivity of the breath tests or the stool test.

Cited by 118 publications

References 25 publications

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of &lt;i&gt;Helicobacter pylori&lt;/i&gt; Infection in Children

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of &lt;i&gt;Helicobacter pylori&lt;/i&gt; Infection in Children

An optimized13C-urea breath test for the diagnosis ofH pyloriinfection

Review: Evaluation and management of dyspepsia

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Resources

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A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i> Infection in Children

An optimized¹³C-urea breath test for the diagnosis ofH pyloriinfection