13C-Urea breath test: Reproducibility and association with the severity of Helicobacter pylori-associated antral gastritis

BackgroundThe purpose of the present paper was to assess the reproducibility of the (13)C-urea breath test ((13)C-UBT) and its ability to reflect the level of Helicobacter pylori-associated inflammation.MethodsAsymptomatic H. pylori-positive subjects (n = 21) performed the (13)C-UBT six times. The H. pylori-positive symptomatic subjects (n = 55) performed the (13)C-UBT and had antral biopsies taken for histopathology, culture, urease activity assay and myeloperoxidase activity assay.ResultsNo significant intraindividual variation in (13)C-UBT results were observed for the asymptomatic subjects. The (13)C-UBT results were significantly higher in symptomatic subjects with a moderate to severe gastritis compared to a mild gastritis and to no inflammation (34.5 +/- 4.4 vs 17.7 +/- 2.8 vs 1.7 +/- 0.1, respectively, P < 0.01). The (13)C-UBT results significantly correlated with urease (r = 0.55) and myeloperoxidase activity (r = 0.82) but not with bacterial load. conclusion: The (13)C-UBT is a reproducible determinant of H. pylori infection and non-invasively assesses the severity of antral inflammation.Matthews, Geoffrey M; Cummins, Adrian G; Lawrence, Andrew; Johnson, Bruce; Campbell, Fiona; Butler, Ross