[Helicobacter pylori: 14C urea breath test in clinical practice at a general hospital]

Using isotope methods we studied in 125 patients the absence or presence of gastric urease. Carbon 14 urea was given orally, breath samples were collected over a 30 min period, and the amount of 14CO2 excreted every 10 min was determined. The patients were divided in two groups: 1) uninfected with Helicobacter pylori (HP) (n = 64), 2) infected (n = 41), depending on whether the excretion of the 14CO2 in the breath was greater o lower that 1% of the administered dose. Compared with the infected patients the uninfected patients have shown a mean values of 14CO2 in the breath significantly lower at 10-20-30 min. Among 38 patients who underwent both the 14C urea breath test and endoscopy biopsy of the antral mucosa for histological examination, 22 (58%) and 16 (42%) showed positive or negative HP on biopsy respectively. Among these HP-positive patients, 16 (73%) had chronic gastritis, 3 (14%) gastritis acute and 3 (14%) had duodenal ulcer. Excretion of 14CO2 in breath, lower than 1% and higher than 1% has a specificity of 81% and sensitivity accuracy, positive predictive power of 86%, 84% and 86% respectively. In conclusion 14C urea breath test is a simple noninvasive and easy way to detect with high degree of confidence the presence or absence of gastric urease.