Time-optimized carbon-14 breath test for Helicobacter pylori contamination of the stomach.

ABSTRACT

PURPOSE: Evidence that Helicobacter pylori plays an important role in peptic ulcer disease has generated intense interest in the development of various screening strategies. H. pylori can be detected high sensitivity and specificity by the noninvasive carbon-14 (C-14) breath test. METHODS: The authors assessed the cost-effectiveness of screening patients with dyspepsia before endoscopy. Thirty-four patients with dyspepsia were evaluated by the C-14 breath test, and then the authors reevaluated the criteria for the diagnosis of H. pylori. The discrimination obtained by using values of cumulative radioactivity or specific activity of breath samples collected between 10 and 60 minutes were studied. RESULTS: The main feature of H. pylori colonization in the stomach was a rapid increase of carbon dioxide in expired breath within 10 minutes after oral administration of C-14. Performance of the test was equally excellent for 10-minute values and 60-minute cumulative excretion. CONCLUSION: The C-14 breath test is a reliable method for diagnosing H. pylori colonization in the stomach, and the accuracy is not compromised by reducing the sample time to maintain better cost-effectiveness and patient acceptance.