UREASE-BASED TESTS FOR HELICOBACTER-PYLORI GASTRITIS - ACCURATE FOR DIAGNOSIS BUT POOR CORRELATION WITH DISEASE SEVERITY

To determine whether the urease-based CLOtest or low-dose C-14 urea br eath test can predict severity of gastritis or the presence of peptic ulcers, we studied 84 patients presenting for upper endoscopy. Antral biopsies were obtained for histologic analysis and CLOtesting, and ure a breath testing was performed. The time to a positive CLOtest and the breath test peak values were correlated with endoscopic findings, sev erity of gastritis, and bacterial burden. Twenty-four patients had pos itive urea breath test results (22 with positive CLOtests). Patients w ith positive breath test results were more likely to have duodenal ulc ers, higher grades of gastritis, and increased bacterial burden (p < 0 .01 for all comparisons). Correlation between the time to a positive C LOtest or peak breath test values and gastritis severity or bacterial burden was poor (p > 0.05 for all comparisons). In patients with posit ive tests, no difference was observed between the lime to a positive C LOtest or peak breath test value in patients with or without peptic ul cers (p < 0.2 for all comparisons). The low-dose C-14 urea breath test and the CLOtest are both accurate for Helicobacter pylori diagnosis. However, neither test predicts the severity of the gastritis, the degr ee of bacterial burden, or the presence of peptic ulcers.