Skip to main content
NCBI home page
Atencion Primaria logoLink to Atencion Primaria
. 2013 Apr 5;31(2):93–97. [Article in Spanish] doi: 10.1016/S0212-6567(03)79144-6

¿Es fiable el test del aliento para el diagnóstico de infección por Helicobacter pylori en atención primaria?

Is the breath test reliable in primary care diagnosis of helicobacter pylori infection?

J Valdepérez a, R Vicente b, MP Novella a, L Valle a, B Sicilia b, C Yus c, F Gomollón b,*
PMCID: PMC7684230  PMID: 12609106

Abstract

Objective

To evaluate the reliability of the breath test urea 13C in the primary care for the diagnosis of Helicobacter pylori (Hp) infection.

Design

Descriptive, prospective and multicentric.

Location

Urban area belonging to the Health Center Actur Sur of Zaragoza with participation of Miguel Servet Hospital.

Participants

87 patients with clinical diagnosis of functional dispepsia. In all of them was made a breath test with 13C urea as well as a gastroscopy with taking of samples for histology and ureasa fast test.

Main measurements

Age, sex and the presence of positivity or negativity of infection by Hp were valued in the histology, ureasa test and in the breath test, considering the histology and the ureasa test like gold tests for this measurement, reason why it was demanded that the positive or outside negative result in both considering it nonambiguous.

Results

Two cases were excluded by ambiguous results. The 77.6% (66/85) were positive by histology and ureasa test, and these, 92.4% (61/66) were positives to the breath test. The sensitivity of this test was 92% and the specificity 100%.

Conclusions

The breath test in primary care has a high value diagnosis of Hp infection, being able to avoid, in some cases, another invasives techniques like gastroscopy.

Bibliografía

  • 1.Bytzer P. Diagnosing dyspepsia: any controversies left? Gastroenterology. 1996;110:302–306. doi: 10.1053/gast.1996.v110.agast960302. [DOI] [PubMed] [Google Scholar]
  • 2.Talley N.J., Stanghellini V., Heading R.C., Koch K.L., Malagelada J.R., Tytgat G.N.J. Functional gastroduodenal disorders. Gut. 1999;45(Suppl II):37–42. doi: 10.1136/gut.45.2008.ii37. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.Kray E. Nonulcer dyspepsia introduction: epidemiological data. Scand J Gastroenterol. 1982;17:6–8. [PubMed] [Google Scholar]
  • 4.Tibblin G. Introduction to the epidemiology of dyspepsia. Scand J Gastroenterol. 1985;20(Suppl 109):29–33. doi: 10.3109/00365528509103932. [DOI] [PubMed] [Google Scholar]
  • 5.Penston J.G., Pounder R.E. A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther. 1996;10:83–89. doi: 10.1111/j.1365-2036.1996.tb00180.x. [DOI] [PubMed] [Google Scholar]
  • 6.Knill-Jones R.P. Geographical differences in the prevalence of dyspepsia. Scand J Gastroenterol. 1991;26(Suppl 182):17–24. doi: 10.3109/00365529109109532. [DOI] [PubMed] [Google Scholar]
  • 7.Benavent J., Martinez G., Pinyol M., Cano J. La dispepsia funcional en atención primaria. In: Mearin F., editor. Dispepsia funcional: tan desconocida como frecuente. Doyma; Barcelona: 1997. pp. 19–30. [Google Scholar]
  • 8.Halley N.J. Drug treatment of functional dyspepsia. Scand J Gastroenterol. 1991;26:47–60. [PubMed] [Google Scholar]
  • 9.Stanghellini V., Tosetti C., Barbara G., Salvioli B., De Giorgio R., Corinaldesi R. Management of dyspeptic patients by general practitioners and specialists. Gut. 1998;43(Suppl 1):21–23. doi: 10.1136/gut.43.2008.s21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Current European concepts in the management of Helicobacter pylori infection The Maastricht Consensus Report. European Helicobacter pylori Study Group. Gut. 1997;41:8–13. doi: 10.1136/gut.41.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Collet J.A., Buert M.J., Frampton C.M., KH. Chapman T.M., Buttimore R.C. Seroprevalence of Helicobacter pylori in the adult population of Christchurch: risk factors and relationship to dyspeptic symptoms and iron studies. N Z Med J. 1999;112:292–295. [PubMed] [Google Scholar]
  • 12.Lassen A.T., Pedersen F.M., Bytzer P., Schaffalitzky de Muckadell O.B. H. pylori «test and treat» strategy or prompt endocopy for dyspeptic patients in prymari care. A randomized controlled trial of two management strategies: one year follow-up (resumen) Gastroenterology. 1998;114:A24. [Google Scholar]
  • 13.Jones R.H., Tait C., Sladen G.E., Weston-Baker J. A Helicobacter test and treat strategy: costs and outcomes in a randomized controlled trial in prymari care (resumen) Gastroenterology. 1998;114:20. [Google Scholar]
  • 14.Gisbert J.P., Pajares J.M. Helicobacter pylori «test-and-scope» strategy for dyspeptic patients. Helicobacter. 2000;5:57–68. doi: 10.1046/j.1523-5378.2000.00009.x. [DOI] [PubMed] [Google Scholar]
  • 15.Calvet X., Brullet E., Campo R., Panades A., Por J.M. Dispepsia, Helicobacter pylori y endoscopia. Gastroenterol Hepatol. 2000;23:206–210. [PubMed] [Google Scholar]
  • 16.Klein P.D., Malaty H.M., Martin R.F., Graham K.S., Genta R.M., Graham D.Y. Non-invasive detection of Helicobacter pylori infection in clinical practice; The 13C urea breath test. Am J Gastroenterol. 1996;91:690–694. [PubMed] [Google Scholar]
  • 17.Valle L.M., Valdepérez J., Tirado M., Verduras D., Yus C., Gomollón F. Fracaso de la serología rápida para Helicobacter pylori como método diagnóstico en la consulta de atención primaria. Aten Primaria. 2001;28:126–128. doi: 10.1016/S0212-6567(01)78912-3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Gisbert J.P., Cruzado A.I., Cabrera M.M., Carpio D., Benito L.M., Perez Poveda J.J. Serología «rápida» para el diagnóstico de infección por H. pylori. Estudio de su validez frente a un patrón de referencia y de su concordancia con la serología «clásica». Gastroenterol Hepatol. 2000;23:159–164. [PubMed] [Google Scholar]
  • 19.Delaney B., Hobbs F.D., Wilson S. Validation of a rapid whole blood test for diagnosing Helicobacter pylori infection. Tests needs full evaluation in primary care. BMJ. 1997;314:1689–1690. [PMC free article] [PubMed] [Google Scholar]
  • 20.Pérez García J.I., Pajares García J.M., Jimenez Alonso I. Prueba del aliento con urea marcada con carbono 13 para el diagnóstico de la infección por Helicobacter pylori en la mucosa gástrica. Validación del método. Rev Esp Enferm Dig. 1996;88:202–208. [PubMed] [Google Scholar]
  • 21.Lee H.S., Gwee K.A.A., Teng L.Y., Kang J.Y., Yeoh K.G., Wee A., Chua B.C. Validation of 13C urea breath test for Helicobacter pylori using a simple gas chromatograp-mass selective detector. Eur J Gastroenterol Hepatol. 1998;10:569–572. doi: 10.1097/00042737-199807000-00008. [DOI] [PubMed] [Google Scholar]
  • 22.Bazzoli F., Cecchini L., Corvaglia L., Dall’Antonia M., De Giacomo C., Fossi S. Validation of 13C urea breath test for the diagnosis of Helicobacter pylori infection in children: a multicenter study. Am J Gastroenterol. 2000;95:646–650. doi: 10.1111/j.1572-0241.2000.01836.x. [DOI] [PubMed] [Google Scholar]
  • 23.Laheÿ R.J., De Boer W.A., Jansen J.B., Van Lier H.J., Sneeberger P.M., Verbeek A.L. Diagnostic performance of biopsy-based methods for determination of Helicobacter pylori infection without a reference standard. J Clin Epidemiol. 2000;53:742–746. doi: 10.1016/s0895-4356(99)00222-x. [DOI] [PubMed] [Google Scholar]
  • 24.Hackelsberger A., Schultze V., Peitz U., Günter T., Nilius M., Diete U. Performance of a rapid whole blood test for Helicobacter pylori in primary care: a German multicentre study. Helicobacter. 1998;3:179–183. doi: 10.1046/j.1523-5378.1998.08002.x. [DOI] [PubMed] [Google Scholar]
  • 25.Gisbert J.P. Revisión crítica de los métodos diagnósticos de infección por Helicobacter pylori. Gastroenterol Hepatol. 2000;23:135–143. [PubMed] [Google Scholar]
  • 26.Kroser J.A., Faigel D.O., Furth E.E., Metz D. Comparison of rapid office-based serology with formal laboratory-based ELISA testing for diagnosis of Helicobacter pylori gastritis. Dig Dis Sci. 1998;43:103–108. doi: 10.1023/a:1018832306135. [DOI] [PubMed] [Google Scholar]
  • 27.Patel P., Khulusi S., Mendall M.A., Lloyd R., Jazrawi R., Maxwell J.D. Prospective screening of dyspeptic patients by Helicobacter pylori serology. Lancet. 1995;346:1315–1318. doi: 10.1016/s0140-6736(95)92340-3. [DOI] [PubMed] [Google Scholar]
  • 28.Huelin J., Sánchez-Galdón S., Cárdenas A., Ibáñez J., España P., De la Cruz J. Estudio comparativo entre Helisal TM Rapid Blood y Elisa, Jatrox y anatomía patológica en el diagnóstico de la infección por Helicobacter pylori. Rev Esp Enferm Dig. 1996;88:825–827. [PubMed] [Google Scholar]
  • 29.Sáinz R., Borda F., Domínguez E., Gisbert J.P. Grupo Conferencia Española de Consenso sobre la infección por Helicobacter pylori. Rev Esp Enferm Digest. 1999;91:777–784. [PubMed] [Google Scholar]
  • 30.González-Cuevas A., Juncosa T., Jené M., Varea V., Gené A., Muñoz C., Latorre C. Infecciones por Helicobacter pylori: detección de antígeno en muestras fecales. Enferm Infecc Microbiol Clin. 2001;19:49–52. doi: 10.1016/s0213-005x(01)72559-1. [DOI] [PubMed] [Google Scholar]

Articles from Atencion Primaria are provided here courtesy of Elsevier

RESOURCES