Comparison of the 13C-urea breath test and the endoscopic phenol red mucosal pH test in the quantification of Helicobacter pylori infection loading.
10.3904/kjim.2008.23.3.134
- Author:
Young Seok CHO
1
;
Hiun Suk CHAE
;
Se Na JANG
;
Jin Soo KIM
;
Hye Suk SON
;
Hyung Keun KIM
;
Byung Wook KIM
;
Sok Won HAN
;
Kyu Yong CHOI
;
Hae Kyung LEE
;
Eun Deok CHANG
Author Information
1. Department of Internal Medicine, Division of Gastroenterology, The Catholic University of Korea, College of Medicine Seoul, Korea. chs@catholic.ac.kr
- Publication Type:Original Article ; Comparative Study
- Keywords:
Helicobacter pylori;
Mucosal surface pH;
Phenol red;
Urea breath test
- MeSH:
Adult;
Aged;
Breath Tests;
Clinical Enzyme Tests;
*Endoscopy, Gastrointestinal;
*Esophageal pH Monitoring;
Female;
Gastric Mucosa/pathology;
Helicobacter Infections/*diagnosis;
Helicobacter pylori/*isolation & purification;
Humans;
Male;
Middle Aged;
Phenolsulfonphthalein/*diagnostic use;
Urease/*diagnostic use
- From:The Korean Journal of Internal Medicine
2008;23(3):134-139
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The 13C-urea breath test (UBT) is a semiquantitative test for measuring Helicobacter pylori infection loading. H. pylori produces ammonia, which elevates the pH of the gastric mucosa and is detectable via endoscopy using a phenol red indicator. We evaluated whether this test could be used to diagnose H. pylori infection and whether phenol red staining was correlated with 13C-UBT results. METHODS: One hundred and twenty-three patients participated. The UBT was performed after ingestion of a capsule containing urea. A change in 13C-UBT >2 ppt was selected as the cutoff value for diagnosing infection. After spraying evenly with a 0.1% phenol red solution, the pH of the gastric mucosal surface was measured using an antimony electrode through the biopsy channel. RESULTS: The pH of stained mucosa (6.9+/-0.4) was significantly higher than that of unstained mucosa (1.9+/-0.8; p<0.001), and the H. pylori detection rate confirmed via histology was higher in stained versus unstained mucosa (p<0.01). Extensive mucosal staining resulted in a higher detection rate (p<0.001). The UBT produced results were very similar to those obtained via histological detection in stained mucosa (p<0.001). The extent of staining, expressed as a staining score, was positively correlated with the change in 13C-UBT (r=0.426, p<0.001). A significant correlation was also observed between the histologically determined H. pylori density and 13C-UBT results (r=0.674, p<0.001). CONCLUSIONS: H. pylori infection elevates gastric mucosal surface pH, and endoscopic phenol red staining may be an alternative method for the diagnosis of H. pylori infection.
