USE OF THE C-14 BREATH TEST IN THE TREATMENT OF HELICOBACTER-PYLORI

Fifty-two patients with gastric disorders referred to the same physici an over the course of one year were endoscoped, biopsied and given a C -14 breath test to identify Helicobacter pylori. Sensitivity, specific ity and accuracy of the C-14 breath test were found to be 83%, 89% and 87%, respectively, when taking biopsy results as the 'gold standard'. These figures rose to 85%, 93% and 89%, respectively, when the first five cases were not included, representing a 'learning curve'' associa ted with the development of cut-off levels for the breath test. In fiv e cases, persons were biopsied and given a breath test at least one mo nth later, making 10 comparisons possible. Biopsy and breath test corr esponded in nine of 10 comparisons (90%). In two of four false negativ es (C-14 breath test negative but biopsy positive) only scant numbers of helicobacter organisms were found. In one of three false positives (C-14 breath test positive but biopsy negative) acute inflammation of the duodenal biopsied material was detected. Also, double eradication therapy (omeprazole 20 mg bid and amoxicillin trihydrate 1000 mg bid), administered in all three false positive cases, was followed by C-14 breath testing six weeks later, which indicated normal scores or absen ce of the organism.