The urea breath test is a rapid diagnostic procedure used to identify infections by Helicobacter pylori, a spiral bacterium implicated in gastritis, gastric ulcer, and peptic ulcer disease. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide. Urea breath tests are recommended in leading society guidelines as a preferred non-invasive choice for detecting H. pylori before and after treatment.[1][2]
Urea breath test
Urea breath test, UBT-KIT for "Helicobacter pylori", (Ubit Tab; left)
Patients swallow urea labelled with an uncommon isotope, either radioactivecarbon-14 or non-radioactive carbon-13. In the subsequent 10–30 minutes, the detection of isotope-labelled carbon dioxide in exhaled breath indicates that the urea was split; this indicates that urease (the enzyme that H. pylori uses to metabolize urea) is present in the stomach, and hence that H. pylori bacteria are present.
For the two different forms of urea, different instrumentation is required. Carbon-14 is normally measured by scintillation, whereas carbon-13 can be detected by isotope ratio mass spectrometry or by mass correlation spectrometry. For each of these methods, a baseline breath sample is required before taking the isotope-labeled urea, for comparison with the post-urea sample, with a 20- to 30-minute duration between them. Samples may be sent to a reference laboratory for analysis. Alternatively, mass correlation spectrometry can be performed as an office-based test since breath samples are continuously collected, and results are provided immediately within minutes.[3][4]
The difference between the pre- and post urea measurements is used to determine infection. This value is compared to a cut-off value. Results below the value are assumed to be negative, those above positive. The cut-off value itself is determined by comparing the results of patients with two or more different detection methods. The value is chosen that gives the best combination of sensitivity and specificity. Both carbon-14 and carbon-13 urea breath tests have high sensitivity and specificity, though the carbon-13 test is preferred in certain populations due to its non-radioactive nature.[5]
The test measures active H. pylori infection. If antibiotics are depressing the amount of H. pylori present, or the stomach conditions are less acidic than normal, the amount of urease present will be lessened.
Accordingly, the test should only be performed 14 days after stopping acid reducing medication (proton pump inhibitors, PPI) or 28 days after stopping antibiotic treatment. Some clinicians believe that a reservoir of H. pylori in dental plaque can affect the result.[6]
^Chey, William; Wong, BC; Practice Parameters Committee of the American College of Gastroenterology (2007). "American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection" (PDF). Am J Gastroenterol. 102 (8): 1808–1825. hdl:2027.42/73792. PMID 17608775.
^Malfertheiner, P; Megraud, F; O'Morain, C; Bazzoli, F; El-Omar, E; Graham, D; Hunt, R; Rokkas, T; et al. (2007). "Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report". Gut. 56 (6): 772–781. doi:10.1136/gut.2006.101634. PMC1954853. PMID 17170018.
^Shirin, H; Kenet, G; Shevah, O; Wardi, Y; Birkenfeld, S; Shahmurov, M; Bruck, R; Niv, Y; et al. (2001). "Evaluation of a novel continuous real time 13C urea breath analyzer for Helicobacter pylori". Aliment. Pharmacol. Ther. 15 (3): 389–394. doi:10.1046/j.1365-2036.2001.00926.x. PMID 11207514.
^Israeli, E; Ilan, Y; Meir, SB; Buenavida, C; Goldin, E (2003). "A novel 13C-urea breath test device for the diagnosis of Helicobacter pylori infection: continuous online measurements allow for faster test results with high accuracy". J Clin Gastroenterol. 37 (2): 139–41. doi:10.1097/00004836-200308000-00009. PMID 12869884.
^Manaf, Mohd Rizal Abdul; Hassan, Mohd Rohaizat; Shah, Shamsul Azhar; Johani, Fadzrul Hafiz; Rahim, Muhammad Aklil Abd (2019-07-24). "13C-Urea Breath Test Accuracy for Helicobacter pylori Infection in the Asian Population: A Meta-Analysis". Annals of Global Health. 85 (1): 110. doi:10.5334/aogh.2570. ISSN 2214-9996. PMC6659579. PMID 31348624.
^Peng NJ, Lai KH, Liu RS, Lee SC, Tsay DG, Lo CC, Tseng HH, Huang WK, Lo GH, Hsu PI (2001). "Clinical significance of oral urease in diagnosis of Helicobacter pylori infection by [13C]urea breath test". Dig Dis Sci. 46 (8): 1772–8. doi:10.1023/A:1010626225949. PMID 11508681.
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January 25, 2023
urea, breath, test, urea, breath, test, rapid, diagnostic, procedure, used, identify, infections, helicobacter, pylori, spiral, bacterium, implicated, gastritis, gastric, ulcer, peptic, ulcer, disease, based, upon, ability, pylori, convert, urea, ammonia, carb. The urea breath test is a rapid diagnostic procedure used to identify infections by Helicobacter pylori a spiral bacterium implicated in gastritis gastric ulcer and peptic ulcer disease It is based upon the ability of H pylori to convert urea to ammonia and carbon dioxide Urea breath tests are recommended in leading society guidelines as a preferred non invasive choice for detecting H pylori before and after treatment 1 2 Urea breath testUrea breath test UBT KIT for Helicobacter pylori Ubit Tab left ICD 9 CM89 39 edit on Wikidata Contents 1 Principles and mechanism 2 See also 3 References 4 External linksPrinciples and mechanism EditPatients swallow urea labelled with an uncommon isotope either radioactive carbon 14 or non radioactive carbon 13 In the subsequent 10 30 minutes the detection of isotope labelled carbon dioxide in exhaled breath indicates that the urea was split this indicates that urease the enzyme that H pylori uses to metabolize urea is present in the stomach and hence that H pylori bacteria are present For the two different forms of urea different instrumentation is required Carbon 14 is normally measured by scintillation whereas carbon 13 can be detected by isotope ratio mass spectrometry or by mass correlation spectrometry For each of these methods a baseline breath sample is required before taking the isotope labeled urea for comparison with the post urea sample with a 20 to 30 minute duration between them Samples may be sent to a reference laboratory for analysis Alternatively mass correlation spectrometry can be performed as an office based test since breath samples are continuously collected and results are provided immediately within minutes 3 4 The difference between the pre and post urea measurements is used to determine infection This value is compared to a cut off value Results below the value are assumed to be negative those above positive The cut off value itself is determined by comparing the results of patients with two or more different detection methods The value is chosen that gives the best combination of sensitivity and specificity Both carbon 14 and carbon 13 urea breath tests have high sensitivity and specificity though the carbon 13 test is preferred in certain populations due to its non radioactive nature 5 The test measures active H pylori infection If antibiotics are depressing the amount of H pylori present or the stomach conditions are less acidic than normal the amount of urease present will be lessened Accordingly the test should only be performed 14 days after stopping acid reducing medication proton pump inhibitors PPI or 28 days after stopping antibiotic treatment Some clinicians believe that a reservoir of H pylori in dental plaque can affect the result 6 See also EditRapid urease test done on biopsy specimens after upper endoscopy Breath testReferences Edit Chey William Wong BC Practice Parameters Committee of the American College of Gastroenterology 2007 American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection PDF Am J Gastroenterol 102 8 1808 1825 hdl 2027 42 73792 PMID 17608775 Malfertheiner P Megraud F O Morain C Bazzoli F El Omar E Graham D Hunt R Rokkas T et al 2007 Current concepts in the management of Helicobacter pylori infection the Maastricht III Consensus Report Gut 56 6 772 781 doi 10 1136 gut 2006 101634 PMC 1954853 PMID 17170018 Shirin H Kenet G Shevah O Wardi Y Birkenfeld S Shahmurov M Bruck R Niv Y et al 2001 Evaluation of a novel continuous real time 13C urea breath analyzer for Helicobacter pylori Aliment Pharmacol Ther 15 3 389 394 doi 10 1046 j 1365 2036 2001 00926 x PMID 11207514 Israeli E Ilan Y Meir SB Buenavida C Goldin E 2003 A novel 13C urea breath test device for the diagnosis of Helicobacter pylori infection continuous online measurements allow for faster test results with high accuracy J Clin Gastroenterol 37 2 139 41 doi 10 1097 00004836 200308000 00009 PMID 12869884 Manaf Mohd Rizal Abdul Hassan Mohd Rohaizat Shah Shamsul Azhar Johani Fadzrul Hafiz Rahim Muhammad Aklil Abd 2019 07 24 13C Urea Breath Test Accuracy for Helicobacter pylori Infection in the Asian Population A Meta Analysis Annals of Global Health 85 1 110 doi 10 5334 aogh 2570 ISSN 2214 9996 PMC 6659579 PMID 31348624 Peng NJ Lai KH Liu RS Lee SC Tsay DG Lo CC Tseng HH Huang WK Lo GH Hsu PI 2001 Clinical significance of oral urease in diagnosis of Helicobacter pylori infection by 13C urea breath test Dig Dis Sci 46 8 1772 8 doi 10 1023 A 1010626225949 PMID 11508681 External links EditTypical testing procedure Retrieved from https en wikipedia org w index php title Urea breath test amp oldid 1112224728, wikipedia, wiki, book, books, library,
