Abstract
The concept of the urea breath test (UBT), as a method for H. pylori detection, is based on the ability of the H. pylori urease enzyme to break down an isotope-labelled urea solution ingested by the patient into carbon dioxide (CO2) and ammonia. This chapter summarizes the current use of the UBT and the utility of the “UBT and Treat” strategy compared to other strategies for the management of H. pylori infection . Different UBT methods are described as well as factors affecting the accuracy of the test.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Warren JR, Marshall B (1983) Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1:1273–1275
Marshall BJ, Warren JR (1984) Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 323:1311–1315
Coghlan JG, Gilligan D, Humphries H et al (1987) Campylobacter pylori and recurrence of duodenal ulcer-a 12 month follow-up study. Lancet 2:1109–1111
Graham DY, Klein PD, Evans DJ Jr et al (1987) Campylobacter pylori detected noninvasively by the 13C-urea breath test. Lancet 1:1174–1177
Marshall BJ, Surveyor I (1988) Carbon-14 urea breath test for the diagnosis of Campylobacter pylori associated gastritis. J Nucl Med 29:11–16
Veldhuyzen van Zanten SJ, Tytgat KM, Hollingsworth J et al (1990) 14C-urea breath test for the detection of Helicobacter pylori. Am J Gastroenterol 85:399–403
Dill S, Payne-James JJ, Misiewicz JJ et al (1990) Evaluation of 13C-urea breath test in the detection of Helicobacter pylori and in monitoring the effect of tripotassium dicitratobismuthate in non-ulcer dyspepsia. Gut 31:1237–1241
Malfertheiner P, Megraud F, O’Morain CA et al (2017) Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 66:6–30
Talley NJ, Vakil NB, Moayyedi P (2005) American Gastroenterological Association technical review on the evaluation of dyspepsia. Gastroenterology 129:1756–1780
Moayyedi P, Axon AT (1999) The usefulness of the likelihood ratio in the diagnosis of dyspepsia and gastroesophageal reflux disease. Am J Gastroenterol 94:3122–3125
Moayyedi P, Deeks J, Talley NJ et al (2003) An update of the Cochrane systematic review of Helicobacter pylori eradication therapy in nonulcer dyspepsia: resolving the discrepancy between systematic reviews. Am J Gastroenterol 98:2621–2626
Howden CW, Blume SW, de Lissovoy G (2007) Practice patterns for managing Helicobacter pylori infection and upper gastrointestinal symptoms. Am J Manag Care 13:37–44
Arents NL, Thijs JC, van Zwet AA et al (2003) Approach to treatment of dyspepsia in primary care: a randomized trial comparing “test-and-treat” with prompt endoscopy. Arch Intern Med 163:1606–1612
Duggan AE, Elliott CA, Miller P et al (2009) Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care. Aliment Pharmacol Ther 29:55–68
McColl KE, Murray LS, Gillen D et al (2002) Randomised trial of endoscopy with testing for Helicobacter pylori compared with non-invasive H pylori testing alone in the management of dyspepsia. BMJ 324:999–1002
Delaney BC, Qume M, Moayyedi P et al (2008) Helicobacter pylori test and treat versus proton pump inhibitor in initial management of dyspepsia in primary care: multicentre randomised controlled trial (MRC-CUBE trial). BMJ 336:651–654
O’Connor A, O’Moráin N, Dobson M et al (2010) Helicobacter pylori eradication treatment is more successful when diagnosis is made after urea breath test than after rapid urease testing at endoscopy in patients with dyspepsia. Gastroenterology 138:S-33
Gatta L, Vakil N, Ricci C et al (2004) Effect of proton pump inhibitors and antacid therapy on 13C urea breath tests and stool test for helicobacter pylori infection. Am J Gastroenterol 99:823–829
Lan HC, Chen TS, Li AFY et al (2012) Additional corpus biopsy enhances the detection of Helicobacter pylori infection in a background of gastritis with atrophy. BMC Gastroenterol 12:182
Weston AP, Campbell DR, Hassanein RS et al (1997) Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 92:1310–1315
Hamlet A, Stage L, Lonroth H et al (1999) A novel tablet-based 13C urea breath test for Helicobacter pylori with enhanced performance during acid suppression therapy. Scand J Gastroenterol 34:367–374
Gatta L, Vakil N, Ricci C et al (2003) A rapid, low-dose, 13C-urea tablet for the detection of Helicobacter pylori infection before and after treatment. Aliment Pharmacol Ther 17:793–798
Liao CC, Lee CL, Chiang TC et al (2002) The 13C-urea breath test to detect Helicobacter pylori infection: a validated simple methodology with 50 mg 13C-urea. Aliment Pharmacol Ther 16:787–792
Malaty HM, El-Zimaity HM, Genta RM et al (1996) Twenty-minute fasting version of the US 13C-urea breath test for the diagnosis of H. pylori infection. Helicobacter 1:165–167
Peng NJ, Lai KH, Liu RS et al (2005) Capsule 13C-urea breath test for the diagnosis of Helicobacter pylori infection. World J Gastroenterol 11:1361–1364
Epple HJ, Kirstein FW, Bojarski C et al (1997) 13C-urea breath test in Helicobacter pylori diagnosis and eradication. Correlation to histology, origin of ‘false’ results, and influence of food intake. Scand J Gastroenterol 32:308–314
Mana F, Franken PR, Ham HR et al (2000) 13C urea breath test with nondispersive isotope-selective infrared spectrometry: reproducibility and importance of the fasting status. Helicobacter 5:104–108
Schoeller DA, Klein PD, Watkins JB et al (1980) 13C abundances of nutrients and the effect of variations in 13C isotopic abundances of test meals formulated for 13CO2 breath tests. Am J Clin Nutr 33:2375–2385
Moayyedi P, Braunholtz D, Heminbrough E et al (1997) Do patients need to fast for a 13C-urea breath test? Eur J Gastroenterol Hepatol 9:275–277
Graham DY, Runke D, Anderson SY et al (1999) Citric acid as the test meal for the 13C-urea breath test. Am J Gastroenterol 94:1214–1217
Shiotani A, Dore MP, Graham DY (2016) Urea breath test and rapid urease test. In: Sazuki H, Warren R, Marshall B (eds) Helicobacter pylori. Springer, Berlin
Osaki S, Mabe K, Hanawa T, Kamiya S (2008) Urease-positive bacteria in the stomach induce a false-positive reaction in a urea breath test for diagnosis of Helicobacter pylori infection. J Med Microbiol 57:814–819
Graham DY, Klein PD (2000) Accurate diagnosis of Helicobacter pylori. 13C-urea breath test. Gastroenterol Clin N Am 29:885–893
Gisbert JP, Pajares JM (2004) 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 20:1001–1017
Kato S, Ozawa K, Konno M et al (2002) Diagnostic accuracy of the 13C-urea breath test for childhood Helicobacter pylori infection: a multicenter Japanese study. Am J Gastroenterol 97:1668–1673
Leal YA, Flores LL, Fuentes-Pananá EM et al (2011) 13C-urea breath test for the diagnosis of Helicobacter pylori infection in children: a systematic review and meta-analysis. Helicobacter 16:327–337
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Science+Business Media, LLC, part of Springer Nature
About this protocol
Cite this protocol
O’Connor, A. (2021). The Urea Breath Test for the Noninvasive Detection of Helicobacter pylori. In: Smith, S.M. (eds) Helicobacter Pylori. Methods in Molecular Biology, vol 2283. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1302-3_2
Download citation
DOI: https://doi.org/10.1007/978-1-0716-1302-3_2
Published:
Publisher Name: Humana, New York, NY
Print ISBN: 978-1-0716-1301-6
Online ISBN: 978-1-0716-1302-3
eBook Packages: Springer Protocols