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Delta 13 C‐urea breath test value is a useful indicator for Helicobacter pylori eradication in patients with functional dyspepsia
Author(s) -
CHANG YOUNGWOON,
MIN SUNKEE,
KIM KYUNGJIN,
HAN YOSEOB,
LEE JOOHEE,
DONG SEOKHO,
KIM HYOJONG,
KIM BYUNGHO,
LEE JOUNGIL,
CHANG RIN
Publication year - 2003
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2003.03049.x
Subject(s) - medicine , gastroenterology , helicobacter pylori , gastritis , breath test , urea breath test , stomach , spirillaceae , lansoprazole , helicobacter pylori infection
Background: Eradication of Helicobacter pylori is not routinely recommended for the symptomatic relief and the prevention of gastric cancer in patients with functional dyspepsia. The present study investigated a useful indicator of H. pylori eradication in such patients by determining the optimal cutoff value of a 13 C‐urea breath test (UBT). Methods: One hundred dyspeptic patients participated in the study. Dyspepsia was scored, and a 13 C‐UBT administered. A level of delta 13 C‐UBT of>4‰ was diagnosed as H. pylori ‐positive. After the stomach was endoscopically sprayed with phenol red, biopsy specimens were taken from the antrum, body and cardia of the stomach for the assessment of H. pylori density, and activity (neutrophil infiltration) and degree (lymphocyte infiltration) of gastritis. Results: Correlation between delta 13 C‐UBT and dyspepsia score was not found. Delta 13 C‐UBT significantly correlated with H. pylori density score in the total stomach ( r = 0.53, P < 0.0001), neutrophil ( r = 0.34, P = 0.0005) and lymphocyte score ( r = 0.69, P < 0.0001). Twenty‐six of the 100 subjects had a neutrophil score of ≥4, lymphocyte score of ≥4, and H. pylori score of ≥4. Their 95% confidence interval of mean was 58.2‰, which reflects moderate to marked acute and chronic gastritis, and dense H. pylori colonization. Conclusions: The 13 C‐UBT is a reliable semiquantitative test to assess H. pylori density and the activity and degree of gastritis. It is proposed that H. pylori eradication therapy might be beneficial for patients with functional dyspepsia with a delta 13 C‐UBT of >58.2‰.