C-13-urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese

Background: Conventional C-13-urea breath testing (C-13-UBT) includes a tes t meal to delay gastric emptying, which, theoretically, improves the accura cy of the test. Citric acid has been proposed as the best test meal. Howeve r, recent studies have suggested that a test meal may not be necessary. Aim: To investigate a new C-13-UBT protocol without a test meal in a Chines e population. Methods: Consecutive dyspeptic patients referred for upper endoscopy were r ecruited. C-13-UBT was performed on two separate days with or without a tes t meal (2.4 Gm citric acid) and compared with the 'gold standard' (CLO test and histology). Results: Two hundred and two patients were tested. Using receiver operating characteristics (ROC) analysis, the optimal delta-value and optimal measur ement interval for UBT were 5% and 30 min, respectively, both with or witho ut a test meal. The sensitivity, specificity, positive predictive value, ne gative predictive value and accuracy of C-13-UBT with citric acid (96.5%, 9 7.7%, 98.2%, 95.6%, 97.0%) were similar to C-13-UBT without a test meal (94 .7%, 97.7%, 98.2%, 93.5%, 96.0%). Conclusion: This simplified C-13-UBT protocol without a test meal produced highly accurate and reliable results in the Chinese population.