Accurate detection of Helicobacter pylori infection with a simplified 13C urea breath test

The urea breath test (UBT) has been shown to be a reliable non-invasive method for detection of H. pylori infection. There is widespread use of a test meal in the 13C UBT, but to what extent exclusion of the test meal actually influences the accuracy of the test has been poorly investigated. In addition, there is variability between test protocols in breath sampling frequency. In this evaluation, 91 patients with dyspeptic symptoms were investigated in an out-patient endoscopy ward, using a simplified 13C UBT without a test meal, and a single point breath evaluation after ingestion of 13C-labelled urea. Helicobacter pylori infection was diagnosed on upper endoscopy by histology and rapid urease tests on biopsies from the antrum and corpus mucosa of the stomach. Fifty-four percent of the patients had H. pylori infection. With the chosen cut-off level, the sensitivity and specificity of the 13C UBT were 92% and 95%, respectively. We conclude that this simplified 13C UBT is easy to perform and a very reliable test for detecting H. pylori infection, making it a suitable test in routine clinical work.