Gastritis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
In ''[[Helicobacter pylori]]'' infection which is the most common cause of gastritis, a non-invasive test such as the [[urea breath test]] is used to determine the presence of H. pylori in the stomach. | |||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
*[[Urea breath test]] identifies active ''[[H. pylori]]'' infection.<ref name="pmid15569102">{{cite journal| author=Gisbert JP, Pajares JM| title=Review article: 13C-urea breath test in the diagnosis of Helicobacter pylori infection -- a critical review. | journal=Aliment Pharmacol Ther | year= 2004 | volume= 20 | issue= 10 | pages= 1001-17 | pmid=15569102 | doi=10.1111/j.1365-2036.2004.02203.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15569102 }} </ref><ref name="pmid11190074">{{cite journal| author=Chey WD| title=Accurate diagnosis of Helicobacter pylori. 14C-urea breath test. | journal=Gastroenterol Clin North Am | year= 2000 | volume= 29 | issue= 4 | pages= 895-902 | pmid=11190074 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11190074 }} </ref> | |||
=== | *'''Procedure:''' | ||
* | :*The [[urea]] labeled with either the nonradioactive isotope <sup>13</sup>C or the radioactive isotope <sup>14</sup>C is ingested. | ||
:*The ''[[H. pylori]]'' [[urease]] converts labeled urea to CO<sub>2</sub>, which can be quantitated in expired breath. | |||
*<sup>13</sup>C labeled urea is preferred in children and pregnant females. | |||
*The [[urea breath test]] has 95% [[sensitivity]] and [[specificity]].<ref name="pmid8540496">{{cite journal| author=Steen T, Berstad K, Meling T, Berstad A| title=Reproducibility of the 14C urea breath test repeated after 1 week. | journal=Am J Gastroenterol | year= 1995 | volume= 90 | issue= 12 | pages= 2103-5 | pmid=8540496 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8540496 }} </ref> | |||
*This test is an accurate means of post-treatment testing.<ref name="pmid10445534">{{cite journal| author=Leodolter A, Domínguez-Muñoz JE, von Arnim U, Kahl S, Peitz U, Malfertheiner P| title=Validity of a modified 13C-urea breath test for pre- and posttreatment diagnosis of Helicobacter pylori infection in the routine clinical setting. | journal=Am J Gastroenterol | year= 1999 | volume= 94 | issue= 8 | pages= 2100-4 | pmid=10445534 | doi=10.1111/j.1572-0241.1999.01284.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10445534 }} </ref><ref name="pmid12425544">{{cite journal| author=Perri F, Manes G, Neri M, Vaira D, Nardone G| title=Helicobacter pylori antigen stool test and 13C-urea breath test in patients after eradication treatments. | journal=Am J Gastroenterol | year= 2002 | volume= 97 | issue= 11 | pages= 2756-62 | pmid=12425544 | doi=10.1111/j.1572-0241.2002.07065.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12425544 }} </ref> | |||
*As this test mainly depends on [[urease]] activity of ''[[H. pylori]]'', the sensitivity of the test is decreased by medications such as [[bismuth]] containing products, [[proton pump inhibitor|PPIs]], and [[antibiotics]] as they reduce organism density or [[urease]] activity. It is recommended to withhold [[proton pump inhibitor|PPIs]] for 7-14 days prior to the test, and [[bismuth]] and [[antibiotics]] are withheld for at least 28 days.<ref name="pmid12809820">{{cite journal| author=Graham DY, Opekun AR, Hammoud F, Yamaoka Y, Reddy R, Osato MS et al.| title=Studies regarding the mechanism of false negative urea breath tests with proton pump inhibitors. | journal=Am J Gastroenterol | year= 2003 | volume= 98 | issue= 5 | pages= 1005-9 | pmid=12809820 | doi=10.1111/j.1572-0241.2003.07426.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12809820 }} </ref><ref name="pmid9068466">{{cite journal| author=Chey WD, Woods M, Scheiman JM, Nostrant TT, DelValle J| title=Lansoprazole and ranitidine affect the accuracy of the 14C-urea breath test by a pH-dependent mechanism. | journal=Am J Gastroenterol | year= 1997 | volume= 92 | issue= 3 | pages= 446-50 | pmid=9068466 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9068466 }} </ref><ref name="pmid9758575">{{cite journal| author=Laine L, Estrada R, Trujillo M, Knigge K, Fennerty MB| title=Effect of proton-pump inhibitor therapy on diagnostic testing for Helicobacter pylori. | journal=Ann Intern Med | year= 1998 | volume= 129 | issue= 7 | pages= 547-50 | pmid=9758575 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9758575 }} </ref> | |||
*[[Antacids]] do not affect the efficacy of the test.<ref name="pmid15128344">{{cite journal| author=Gatta L, Vakil N, Ricci C, Osborn JF, Tampieri A, Perna F et al.| title=Effect of proton pump inhibitors and antacid therapy on 13C urea breath tests and stool test for Helicobacter pylori infection. | journal=Am J Gastroenterol | year= 2004 | volume= 99 | issue= 5 | pages= 823-9 | pmid=15128344 | doi=10.1111/j.1572-0241.2004.30162.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15128344 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category:Medicine]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Up-To-Date]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]
Overview
In Helicobacter pylori infection which is the most common cause of gastritis, a non-invasive test such as the urea breath test is used to determine the presence of H. pylori in the stomach.
Other Diagnostic Studies
- Urea breath test identifies active H. pylori infection.[1][2]
- Procedure:
- 13C labeled urea is preferred in children and pregnant females.
- The urea breath test has 95% sensitivity and specificity.[3]
- This test is an accurate means of post-treatment testing.[4][5]
- As this test mainly depends on urease activity of H. pylori, the sensitivity of the test is decreased by medications such as bismuth containing products, PPIs, and antibiotics as they reduce organism density or urease activity. It is recommended to withhold PPIs for 7-14 days prior to the test, and bismuth and antibiotics are withheld for at least 28 days.[6][7][8]
- Antacids do not affect the efficacy of the test.[9]
References
- ↑ Gisbert JP, Pajares JM (2004). "Review article: 13C-urea breath test in the diagnosis of Helicobacter pylori infection -- a critical review". Aliment Pharmacol Ther. 20 (10): 1001–17. doi:10.1111/j.1365-2036.2004.02203.x. PMID 15569102.
- ↑ Chey WD (2000). "Accurate diagnosis of Helicobacter pylori. 14C-urea breath test". Gastroenterol Clin North Am. 29 (4): 895–902. PMID 11190074.
- ↑ Steen T, Berstad K, Meling T, Berstad A (1995). "Reproducibility of the 14C urea breath test repeated after 1 week". Am J Gastroenterol. 90 (12): 2103–5. PMID 8540496.
- ↑ Leodolter A, Domínguez-Muñoz JE, von Arnim U, Kahl S, Peitz U, Malfertheiner P (1999). "Validity of a modified 13C-urea breath test for pre- and posttreatment diagnosis of Helicobacter pylori infection in the routine clinical setting". Am J Gastroenterol. 94 (8): 2100–4. doi:10.1111/j.1572-0241.1999.01284.x. PMID 10445534.
- ↑ Perri F, Manes G, Neri M, Vaira D, Nardone G (2002). "Helicobacter pylori antigen stool test and 13C-urea breath test in patients after eradication treatments". Am J Gastroenterol. 97 (11): 2756–62. doi:10.1111/j.1572-0241.2002.07065.x. PMID 12425544.
- ↑ Graham DY, Opekun AR, Hammoud F, Yamaoka Y, Reddy R, Osato MS; et al. (2003). "Studies regarding the mechanism of false negative urea breath tests with proton pump inhibitors". Am J Gastroenterol. 98 (5): 1005–9. doi:10.1111/j.1572-0241.2003.07426.x. PMID 12809820.
- ↑ Chey WD, Woods M, Scheiman JM, Nostrant TT, DelValle J (1997). "Lansoprazole and ranitidine affect the accuracy of the 14C-urea breath test by a pH-dependent mechanism". Am J Gastroenterol. 92 (3): 446–50. PMID 9068466.
- ↑ Laine L, Estrada R, Trujillo M, Knigge K, Fennerty MB (1998). "Effect of proton-pump inhibitor therapy on diagnostic testing for Helicobacter pylori". Ann Intern Med. 129 (7): 547–50. PMID 9758575.
- ↑ Gatta L, Vakil N, Ricci C, Osborn JF, Tampieri A, Perna F; et al. (2004). "Effect of proton pump inhibitors and antacid therapy on 13C urea breath tests and stool test for Helicobacter pylori infection". Am J Gastroenterol. 99 (5): 823–9. doi:10.1111/j.1572-0241.2004.30162.x. PMID 15128344.