Urea breath test sensitivity seems affected by increased intragastric acidity during therapy with antisecretory drugs.
Intragastric pH is increased in patients with corpus gastritis with or without atrophy.
Dr Bruno Annibale and colleagues from Italy tested the hypothesis that urea breath test results may be affected by this gastritis phenotype.
The investigative team reported that 123 untreated patients underwent gastroscopy plus biopsies, and intragastric pH measurement.
The team offered urea breath test with an acidic meal to 82 endoscopically proven Helicobacter pylori-positive patients.
|32% of patients had a false-negative urea breath test|
|Alimentary Pharmacology & Therapeutics|
Histological findings, urea breath test results and intragastric pH were compared in 66 of the subjects.
The investigators found that 32% of patients had a false-negative urea breath test.
In these patients corpus-predominant gastritis, and fundic atrophy were more frequent than in patients with true-positive urea breath test.
The investigators noted that intragastric pH was higher in false-negative patients.
The team found that the only risk factor for a false-negative urea breath test was the presence of corpus-predominant gastritis.
There was a negative correlation between the intragastric pH and the delta over baseline values.
Dr Annibale's team comments, “Our results support the hypothesis that the pattern of gastritis can affect the sensitivity of urea breath test.”
“Our findings also suggest that patients with corpus-predominant gastritis have a high risk of false-negative urea breath test results.”