Ulcers: The non-invasive way to detect peptic ulcers

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The year is 1876. The place, a village in rural England. Advice: Dont get sick.

A man lies unconscious on a wooden floor. He is in septic shock from kidney stones that have blocked his bladder. With great apprehension a doctor administers a rudimentary invasive treatment. The anguished cries of the patient can be heard throughout the small town.

Frightening thought?

Thankfully, were extremely fortunate to live in an age when medical treatments are as non-invasive as possible.

Fast-forward to 2005 and the release of a new study that demonstrates the effectiveness of a non-invasive test to detect a specific bacterial infection that can wreak considerable havoc on your health.

The breathalyser
H. pylori is a bacterium that creates peptic ulcers by weakening the protective coating of the stomach and duodenum (the section of intestine just below the stomach), allowing acid to irritate the sensitive stomach lining.

Research shows that infection by this bacterium may play a role in the development of heart disease, autoimmune diseases and skin diseases. The most recent studies even suggest a link between H. pylori and several different cancers, including those of the stomach, pancreas and larynx.

The most common procedure to investigate upper gastrointestinal symptoms like peptic ulcers is called endoscopy. This is an uncomfortable process that requires a narrow tube to be inserted into the stomach via the mouth. But there is a simpler, non-invasive breath test to detect H. pylori infection.

The Urea Breath Test (UBT) is one of four non-invasive H. pylori (Hp) tests that were compared in a recent trial conducted by the European Paediatric Task Force. The other three non-invasive tests included a stool antigen test, and two antibody detection tests using blood and urine samples.

All of the subjects in the study were children (most adults who are infected with H. pylori pick up the bacterium during childhood). Of the more than 300 children who completed the study, about 40 per cent proved to be Hp positive, while nearly 60 percent were Hp negative.

Measuring percentages of sensitivity and specificity of the four tests, researchers produced this data:

  • Stool antigen: 73 and 97 per cent
  •  Urine antibody: 63 and 97 per cent
  •  Serum antibody: 89 and 93 per cent
  •  Urea breath test: 96 and 97 per cent

Their conclusion: The UBT appears to be an excellent test for diagnosis of H. pylori infection for children and adolescents.

High comfort 
If you have reason to believe that you may have a peptic ulcer, ask your doctor about the availability of a UBT (also known as a 13C-urea breath test).

In a past e-alert I told you about a University of Glasgow test in which subjects were asked to score the degree of discomfort or distress caused by a UBT or an endoscopy. No surprise really that the group using the breath test scored their test higher in comfort and lower in distress. The breath test has an economic advantage as well, costing approximately half the price of an endoscopy procedure.

The Glasgow study also found UBT to be just as effective as endoscopy in detecting H. pylori. Bear in mind, however, that UBT is not able to detect other health problems not associated with H. pylori. For instance, the breath test would not detect a tumour, whereas the endoscopy would.

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