Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 May;14(3):278-82.
doi: 10.5811/westjem.2012.12.15173.

Rapid (13)C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain

Andrew C Meltzer  1 , Rebecca Pierce, Derek A T Cummings, Jesse M Pines, Larissa May, Meaghan A Smith, Joseph Marcotte, Melissa L McCarthy
Affiliations

Rapid (13)C Urea Breath Test to Identify Helicobacter pylori Infection in Emergency Department Patients with Upper Abdominal Pain

Andrew C Meltzer et al. West J Emerg Med. 2013 May.

Abstract

Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing.

Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February 2011 until February 2012 at a single academic urban ED. Enrolled subjects were tested for H. pylori using a rapid point of care (13)C Urea Breath Test (UBT) [Exalenz Bioscience]. We compared patient characteristics between those who tested positive versus negative for the disease.

Results: A total of 205 patients with upper abdominal pain were tested over 12 months, and 24% (95% confidence interval: 19% to 30%) tested positive for H. pylori. Black subjects were more likely to test positive than white subjects (28% v. 6%, P < 0.001). Other factors, such as age and sex, were not different between the 2 groups.

Conclusion: In our ED, H. pylori infection was present in 1 in 4 patients with epigastric pain, and testing with a UBT was feasible. Further study is needed to determine the risk factors associated with infection, the prevalence of H. pylori in other EDs, the effect of the test on ED length of stay and the costeffectiveness of an ED-based test-and-treat strategy.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Figure.
Figure.
Nasal cannula attached to the BreathID device.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Non-invasive diagnostic tests for Helicobacter pylori infection.
    Best LM, Takwoingi Y, Siddique S, Selladurai A, Gandhi A, Low B, Yaghoobi M, Gurusamy KS. Best LM, et al. Cochrane Database Syst Rev. 2018 Mar 15;3(3):CD012080. doi: 10.1002/14651858.CD012080.pub2. Cochrane Database Syst Rev. 2018. PMID: 29543326 Free PMC article.

References

    1. Azevedo NF, Huntington J, Goodman KJ. The epidemiology of helicobacter pylori and public health implications. Helicobacter. 2009;14(Suppl 1):1–7. - PubMed
    1. McQuillan GM, Kruszon-Moran D, Kottiri BJ. Racial and ethnic differences in the seroprevalence of 6 infectious diseases in the united states: Data from NHANES III, 1988–1994. Am J Public Health. 2004;94(11):1952–1958. et al. - PMC - PubMed
    1. den Hoed CM, Vila AJ, Holster IL. Helicobacter pylori and the birth cohort effect: Evidence for stabilized colonization rates in childhood. Helicobacter. 2011;16(5):405–409. et al. - PMC - PubMed
    1. Chey WD, Wong BC. American college of gastroenterology guideline on the management of helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808–1825. Practice Parameters Committee of the American College of Gastroenterology. - PubMed
    1. Gisbert JP, Pajares JM. Review article: 13C-urea breath test in the diagnosis of helicobacter pylori infection -- a critical review. Aliment Pharmacol Ther. 2004;20(10):1001–1017. - PubMed