Urea Breath Test for Diagnosis of Peptic Ulcer

Peptic ulcer (ulcer in the stomach and duodenum) is a common health problem. One of the most common causes of peptic ulcer is infection of H. pylori in the gastrointestinal tract (mainly stomach). Other important causative factors for peptic ulcer are acid (high gastric hydrochloric acid production), stress, certain medications (such as NSAIDs e.g. ibuprofen, diclofenac etc.), disbalance between protective factors and aggressive factors active in the stomach and duodenum.

If you are suffering from peptic ulcer or gastritis, your doctor will try to find out the cause of your peptic ulcer or gastritis and for finding out the cause, your doctor will ask for urea breath test, which is used to detect H. pylori infection in the stomach.

How urea breath test is performed?

In nature the number of radioactive carbon-14 is fixed. For performing urea breath test, the patient is given capsule or liquid containing urea with radioactive carbon-14 (or sometimes non radioactive carbon-13). If patient is infected with H. pylori, the urea will break down to carbon dioxide and ammonia. The carbon dioxide is carried via blood stream to lungs and exhaled out. Several samples of exhaled air are collected after 10-30 minutes of ingesting capsule or liquid containing urea with radioactive carbon-14. The radioactive carbon-14 isotopes are counted using a special counter and compared with normal exhaled air collected before test. If numbers of radioactive carbon-14 are more in the test samples, it indicates infection with H. pylori. In absence of H. pylori infection the urea can not be broken down to carbon dioxide and ammonia and the number of radioactive carbon-14 isotopes will be same in test sample and normal exhaled air that is collected before performing the urea breath test.

Enzyme urease (the enzyme which metabolizes urea) is present in H. pylori and in absence of the organism urea can not be metabolized to form ammonia and carbon dioxide.

Once you are diagnosed to be suffering from peptic ulcer or gastritis due to H. pylori infection, your doctor will prescribe antibiotics and other medications for eradication of the organism from your stomach. After completion of treatment (i.e. eradication of H. pylori) your doctor may ask again for urea breath test and this time to determine if eradication of H. pylori is successful or not. Negative urea breath test is indicative of successful treatment for eradication of H. pylori.

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