Comparison of different protocols for ¹³C‐urea breath test for the diagnosis of Helicobacter pylori infection in healthy volunteers

Abstract

Objective. The ¹³C‐urea breath test (¹³C‐UBT) is the most accurate non‐invasive method for diagnosis of Helicobacter pylori infection. However, several methodological issues have not been resolved yet. The aim of this study was to test different protocols of ¹³C‐UBT to find the optimal test drink and sampling interval. Material and methods. ¹³C‐UBT was performed at 3‐day intervals in 27 healthy volunteers using citric acid (test A), orange juice (B) and still water (C) as test drinks. Breath samples were collected from time 5 to 60 min. A total number of 2106 breath samples were analysed by isotope ratio mass spectrometry (cut‐off value 3.5). Results. Differences in delta values were greater than would be expected by chance (A versus B and A versus C at times 20, 25, 30, 35 and 40 min, p<0.05, Dunnett's method). There were no grey zone‐ or false‐negative results among H. pylori‐positive persons in test A at any time, but some were found in tests B and C. Optimal intervals for breath sampling are at times 20 or 25 min after ¹³C‐urea ingestion. Conclusions. Citric acid solution as a test drink and 20‐ or 25‐min breath sampling intervals are optimal for the ¹³C‐UBT in healthy volunteers.

• Citric acid
• Helicobacter pylori
• isotope ratio mass spectrometry
• test drink
• ¹³C‐urea breath test

Acknowledgement

This study was supported by a grant from the Ministry of Health of the Czech Republic MZ VZ 000179906.