13C‐Urea Breath Test to Assess Helicobacter pylori Bacterial Load

ABSTRACT Background. Some authors have reported, using different protocols, that 13 C‐urea breath test ( 13 C‐UBT) is capable of assessing the intragastric Helicobacter pylori bacterial load, whereas others have not confirmed these data. Our aim is to evaluate the correlation between 13 C‐UBT values and H. pylori bacterial load. Materials and Methods. One hundred ninety‐two patients diagnosed H. pylori ‐positive by rapid urease test, histology, and 13 C‐UBT were enrolled. H. pylori bacterial load ( H. pylori score) and gastritis activity (activity score) were evaluated according to the Updated Sydney System. 13 C‐UBT was performed according to the European Standard Protocol. Breath samples were obtained every 10 minutes for 60 minutes in 52 patients and at 30 minutes (T 30 ) in 140 patients and analyzed by mass spectrometry. Results. At T 30 , mean ± SD excess delta 13 CO 2 excretion was 17.4 ± 1.1, 29.9 ± 2.2, and 48.7 ± 4.8 in patients with H. pylori scores 1, 2, and 3, respectively. This difference was statistically significant: H. pylori score 1 versus 2, p < .005; score 1 versus 3, p < .05; score 2 versus 3, p < .05. A significant positive correlation ( G = 0.59) was found between H. pylori score and activity score of chronic gastritis. At T 40 and T 50 significant correlation between mean excess delta 13 CO 2 excretion and bacterial load was achieved only in patients with H. pylori scores 1 and 3. Conclusions. 13 C‐UBT European Standard Protocol values correlate with H. pylori bacterial load and the activity of gastritis at T 30 breath sampling time.