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KMID : 0338420080230030134
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The Korean Journal of Internal Medicine
2008 Volume.23 No. 3 p.134 ~ p.139
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Comparison of the 13C-urea breath test and the endoscopic phenol red mucosal pH test in the quantification of Helicobacter pylori infection loading
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Cho Young-Seok
Chae Hiun-Suk
Chang Se-Na
Kim Jin-Soo
Son Hye-Suk
Kim Hyung-Keun
Kim Byung-Wook
Han Sok-Won
Choi Gyu-Yong
Lee Hae-Kyung
Chang Eun-Deok
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Abstract
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Background/Aims: The 13C-urea breath test (UBT) is a semiquantitative test for measuring Helicobacter pylori infection loading. H. pylori produces ammonia, which elevates the pH of the gastric mucosa and is detectable via endoscopy using a phenol red indicator. We evaluated whether this test could be used to diagnose H. pylori infection and whether phenol red staining was correlated with 13C-UBT results.
Methods: One hundred and twenty-three patients participated. The UBT was performed after ingestion of a capsule containing urea. A change in 13C-UBT >2‰ was selected as the cutoff value for diagnosing infection. After spraying evenly with a 0.1% phenol red solution, the pH of the gastric mucosal surface was measured using an antimony electrode through the biopsy channel.
Results: The pH of stained mucosa (6.9±0.4) was significantly higher than that of unstained mucosa (1.9±0.8; p<0.001), and the H. pylori detection rate confirmed via histology was higher in stained versus unstained mucosa (p<0.01). Extensive mucosal staining resulted in a higher detection rate (p<0.001). The UBT produced results were very similar to those obtained via histological detection in stained mucosa (p<0.001). The extent of staining, expressed as a staining score, was positively correlated with the change in 13C-UBT (r=0.426, p < 0.001). A significant correlation was also observed between the histologically determined H. pylori density and 13C-UBT results (r=0.674, p<0.001).
Conclusions: H. pylori infection elevates gastric mucosal surface pH, and endoscopic phenol red staining may be an alternative method for the diagnosis of H. pylori infection.
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KEYWORD
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Helicobacter pylori, Mucosal surface pH, Phenol red, Urea breath test
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