Endoscopic 13C-urea breath test for the diagnosis of Helicobacter pylori infection

Background. Endoscopic C-13-urea breath test may avoid contamination of oral urease and rapidly discriminate Helicobacter pylori-positive and Helicobacter pylori-negative patients. Aims. To compare the accuracy of endoscopic C-13-urea breath test with conventional invasive methods in diagnosis of Helicobacter-pylori infection. Patients. One hundred patients who attended for routine upper gastrointestinal endoscopy were included. Methods. C-13-urea was applied to the stomach through the working channel of endoscope at the end of endoscopic examination. Breath samples were collected before endoscopy and 2, 4, 6, 8, 10 min after consumption of 100 or 50 mg C-13-urea. Helicobacter pylori infection was defined as those with positive culture or positive results of both histology and CLO test. Results. The accuracy of 100 mg endoscopic C-13-urea breath test was significantly higher than that of culture and CLO test (100% vs. 88% and 92%. p=0.02 and 0.03, respectively). The accuracy of 50 mg endoscopic C-13-urea breath test was higher than that of histology and CLO test (98% vs. 90% and 96%, respectively), although the differences were not statistically significant. Conclusions. Endoscopic C-13-urea breath test has a higher accuracy compared with biopsy-based modalities. It may be a good choice to diagnose Helicobacter pylori infection if endoscopy is indicated for a dyspeptic patient. (C) 2003 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Science Ireland Ltd. All rights reserved.