Can urea breath test (UBT) replace rapid urea test (RUT)?

Helicobacter pylori (Hp) is classified by the International Agency for Research on Cancer (IARC) as a Group 1 carcinogen. Its influence on the carcinogenesis of gastric cancer has been confirmed in many researches. The conclusion is obvious- early detection and eradication of Hp can prevent the development of the disease.

The objective of the study was to analyse the clinical and practical value of Carbon-13 urea breath test (UBT) in patients hospitalized due to pain complaints in the upper abdomen and dyspeptic symptoms. Fifty patients were enrolled in the study. Each patient underwent urea breath test according to the instruction included by the producer. Thereafter, each patient included in the study group was performed endoscopy of the upper gastrointestinal tract with the biopsy of the mucosa to determine the urease activity with rapid urease test (RUT).

In the study group, 14 patients (28%) achieved a positive urease test result which was confirmed in RUT. Four (8%) patients, despite a positive breath test, did not have a positive result in urease activity from gastric mucosa. In 2 cases (4%) despite negative result of UBT there was urease actitvity confirmed in gastroscopic sections. The remaining 30 patients (60%) had a negative result in both studies.

The limited availability of the gold standard for diagnostics of upper gastrointestinal tract diseases (gastroscopy) is the basis for the search for new methods for the detection of Helicobacter pylori infection. The urea breath test is a method of high sensitivity and specificity. The positive result of urea breath test may be the basis for the inclusion of eradication therapy.