A Trial of 13 C‐urea Breath Test Combined with Endoscopic Phenol Red Test for Detection of Helicobacter pylori Infection

Several tests for the diagnosis of Helicobacter pylori [H. pylori) infection have been employed in clinical studies. To minimize inaccuracies of these tests, we developed a new method which combines the 13C-urea breath test (UBT) with phenol red dye spraying endoscopy. We have designated this innovation the endoscopic 13C-urea breath test (EUBT). EUBT was conducted on 103 patients with gastroduodenal diseases. After the collection of a baseline breath sample, gastroduodenal endoscopy was performed. Twenty milliliters of 0.05% phenol red solution containing 100 milligrams of 13C-urea was sprayed onto the entire gastric mucosa. A breath sample was collected 15 minutes after spraying. We measured 13CO2 in the breath samples by ratio mass spectrometry. Two biopsy specimens each from the antrum and the middle corpus were obtained for culture and histological examination. The mean EUBT values (±standard deviation) in H. pylori -positive and negative patients were 38.56±30.34%< and 0.19± 0.18%), respectively. The cut-off value for EUBT was 0.73%. The sensitivity and specificity of EUBT were 100% and 95.5%, as compared with culture, and 100% and 95.5%, as compared with histological evaluation. The EUBT value of the patients with the diffuse staining type (50.28±31.26%) was significantly higher than that of patients with the regional staining type (26.76±23.17%). EUBT is an accurate method of detecting H. pylori infection and a good indicator of the distribution of the infection within the stomach.