Detecting Campylobacter pylori with the 13C- and 14C-urea breath test

Campylobacter pylori is a bacterium which has been suggested as a causative agent in active chronic gastritis and possibly peptic ulcer disease. The diagnosis has had to be made by culture or histological examination of gastric mucosal biopsies. Since endoscopy is needed to obtain biopsies, this precludes large-scale epidemiological studies of this organism. Recently Graham described a noninvasive breath test with carbon 13 labelled urea to detect C. pylori colonization. This breath test is based on our finding of the remarkably high urease activity of C. pylori. Ingested labelled urea will be rapidly broken down in the stomach if urease activity, and so C. pylori, is present. Breath samples are collected at 10-minute intervals and analysis from these samples for labelled CO2 content is then made. In the present paper we describe current experience with the 13C- and 14C-urea breath test.