¹³C‐urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese

Abstract

Background: Conventional 13C‐urea breath testing (13C‐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. Aim: To investigate a new 13C‐UBT protocol without a test meal in a Chinese population. Methods: Consecutive dyspeptic patients referred for upper endoscopy were recruited. 13C‐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 13C‐UBT with citric acid (96.5%, 97.7%, 98.2%, 95.6%, 97.0%) were similar to 13C‐UBT without a test meal (94.7%, 97.7%, 98.2%, 93.5%, 96.0%). Conclusion: This simplified 13C‐UBT protocol without a test meal produced highly accurate and reliable results in the Chinese population.

Twenty‐minute 50 mg 13C‐urea breath test without test meal for the diagnosis of Helicobacter pylori infection in Chinese

“…This ®nding correlated well with our previous report using 75 mg 13 C-urea as the substrate 9 and 2.4 g citrate as the test meal, in which the mean DOB was similar for 13 C-UBT with or without citrate at all time intervals from 15 to 60 min. 10 This appears to be a unique observation in the Chinese population and is possibly related to the difference in the distribution, delivery and emptying of 13 C-urea. A similar observation was reported with regard to the parietal cell mass and acid secretory capacity of Asian patients with duodenal ulcer, which are only slightly more than half the values of Caucasian patients despite correction for body stature.…”

“…8,9 The 75 mg 13 C-UBT protocol has been validated in the Chinese population with a sensitivity and speci®city of 96.5% and 97.7%, respectively, with citrate, and 94.7% and 97.7%, respectively, without citrate, using a delta-value of 5& and measurement interval of 30 min. 10 Thus citrate can be omitted without sacri®cing the accuracy of the 13 C-UBT. Others have shown that a 20-min sampling point was similar to the 30-min sampling point for the fasting 13 C-UBT protocol.…”

Helicobacter pyloriDetection and Antimicrobial Susceptibility Testing

“…However, the nonfasting protocol leads to DOB values which increase the risk of negative results when the DOB is close to the cutoff, even if it is infrequent (128). Eliminating the test meal completely has been advocated (577), but this also leads to lower DOB values and the possibility of false-negative results.…”

Update on Clarithromycin Resistance in <i>Helicobacter pylori</i> in Hong Kong and Its Effect on Clarithromycin-Based Triple Therapy

“…The 30-min measurement interval and 5% cut-off value were used in this study. The protocol has been validated in our center, with the sensitivity and the specificity of 96.5 and 97.7%, respectively [15]. …”