scholarly journals CanadianHelicobacter pyloriConsensus Conference Update: Infections in Adults

1999 ◽  
Vol 13 (3) ◽  
pp. 213-217 ◽  
Author(s):  
RH Hunt ◽  
CA Fallone ◽  
ABR Thomson ◽  
Canadian Helicobacter Study Group
Keyword(s):  
Breath Test ◽  
Consensus Conference ◽  
Urea Breath Test ◽  
Antibiotic Resistant ◽  
Ulcer Disease ◽  
Consensus Document ◽  
Bismuth Citrate ◽  
The Subject ◽  
H Pylori ◽  
Study Group Meeting

The first CanadianHelicobacter pyloriConsensus Conference took place in April 1997. The initial recommendations of the conference were published in early 1998. An update meeting was held in June 1998, and the present paper updates and complements the earlier recommendations. Key changes included the following: the recommendation for testing and treatingH pyloriinfection in patients with known peptic ulcer disease was extended to testing and treating patients with ulcer-like dyspepsia; it was decided that the urea breath test (not serology) should be used for routine diagnosis ofH pyloriinfection unless endoscopy is indicated for another reason; and recommended therapies were a twice daily, seven-day regimen of a proton pump inhibitor (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg) or ranitidine bismuth citrate 400 mg, plus clarithromycin 500 mg and amoxicillin 1000 mg, or plus clarithromycin 500 or 250 mg and metronidazole 500 mg. The need was reiterated to have funding for readily accessible, accurate testing forH pyloriinfection with the urea breath test. It was strongly recommended that regional centres be established to monitor the prevalence of antibiotic-resistantH pyloriinfections. The initial consensus document referred to pediatric issues that were not addressed in this update but were the subject of a subsequent CanadianHelicobacterStudy Group meeting, and will be published later in 1999.

Helicobacter pylori causes gastrointestinal hemorrhage in patients with congenital bleeding disorders

2003 ◽  
Vol 89 (04) ◽  
pp. 741-746 ◽  
Author(s):  
Ann-Sofie Rehnberg ◽  
Marju Hein ◽  
Olga Hegedus ◽  
Per Lindmarker ◽  
Per Hellström ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastrointestinal Hemorrhage ◽  
Breath Test ◽  
Eradication Therapy ◽  
Urea Breath Test ◽  
Von Willebrand Disease ◽  
Bleeding Disorders ◽  
Ulcer Disease ◽  
H Pylori ◽  
One Year

Summary Helicobacter pylori (H. pylori) infection is associated with peptic ulcer disease and gastric cancer. The eradication of H. pylori is of special interest in patients with congenital bleeding disorders, for whom treatment of gastrointestinal hemorrhage with factor concentrates is costly. The prevalence of H. pylori varies between different populations and identification of high-risk subgroups may allow for more targeted screening and eradication of the infection. We performed a 5-year retrospective study of gastrointestinal bleeding, combined with screening and treatment for H. pylori and a long-term prospective follow-up in 168 Swedish and 23 Estonian patients with hemophilia or von Willebrand disease. The prevalence of seropositivity was lower in Sweden than in Estonia (28 versus 48%, p = 0.03), lower in native Swedes than in non-Nordic immigrants to Sweden (20 versus 76%, p = 0.0001) and lower in patients less than 40 years of age than older patients (16 versus 38%, p = 0.002). The incidence of gastrointestinal hemorrhages among the 35 Swedish patients with active H. pylori infection, confirmed by a urea breath test, was 6.0 per 100 patient-years before eradication therapy versus 1.7 during the prospective followup. A negative urea breath test one month after therapy always remained negative after one year. Screening, followed by treatment of all infected patients, yielded a reduction of direct costs over a 5-year period of 130 US-$ per screened patient. We conclude that screening and eradication therapy for infection with H. pylori in patients with congenital bleeding disorders is an effective and economic strategy.

scholarly journals Do We EradicateHelicobacter pyloriin Hospitalized Patients with Peptic Ulcer Disease?

2013 ◽  
Vol 27 (11) ◽  
pp. 636-638 ◽  
Author(s):  
Frank Wong ◽  
George Ou ◽  
Sigrid Svarta ◽  
Ricky Kwok ◽  
Kieran Donaldson ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Breath Test ◽  
Upper Gastrointestinal Bleeding ◽  
Urea Breath Test ◽  
Gastric Ulcers ◽  
Treatment Rate ◽  
Ulcer Disease ◽  
Tertiary Centre ◽  
H Pylori ◽  
Upper Gastrointestinal

BACKGROUND:Helicobacter pyloriinfection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates ofH pylori-related ulcers as well as other complications such as gastric cancer.OBJECTIVE: To determine the rate of appropriate treatment in patients following a diagnosis ofH pyloriinfection on biopsy during esophagoduodenoscopy for upper gastrointestinal bleeding over a four-year period at a tertiary centre in Vancouver, British Columbia. Also evaluated was the rate of eradication confirmation using the urea breath test.METHODS: A retrospective review of 1501 inpatients who underwent esophagoduodenoscopy for upper gastrointestinal bleeding (January 2006 to December 2010) was undertaken. Patients who were biopsy stain positive forH pyloriwere selected for drug review either via a provincial database (PharmaNet) or via records from patients’ family practitioners. Data were also obtained via two provincial laboratories that perform the urea breath test to determine the rates of confirmation of eradication.RESULTS: Ninety-eight patients had biopsy-provenH pylori. The mean (± SD) age was 56.13±17.9 years and 65 were male. Data were not available for 22 patients; the treatment rate was 52.6% (40 of 76). Of those treated, 12 patients underwent a post-treatment urea breath test for eradication confirmation.CONCLUSION: There was substantial discrepancy between the number of diagnosedH pyloriinfections and the rate of treatment as well as confirmation of eradication. Numerous approaches could be taken to improve treatment and eradication confirmation.

scholarly journals Development of FlexSure® HP—an immunochromatographic method to detect antibodies against Helicobacter pylori

1998 ◽  
Vol 44 (2) ◽  
pp. 293-298 ◽  
Author(s):  
Wayne H Schrier ◽  
Ronald J Schoengold ◽  
Josefina T Baker ◽  
Joyce L Norell ◽  
Corey L Jaseph ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Solid Phase ◽  
Reverse Flow ◽  
Test Strip ◽  
Urea Breath Test ◽  
Igg Antibodies ◽  
Ulcer Disease ◽  
13C Urea Breath Test ◽  
H Pylori

Abstract We describe a solid-phase immunochromatographic serologic test, FlexSure® HP, to detect IgG antibodies against Helicobacter pylori. H. pylori colonize the stomach and proximal duodenum, cause ulcer disease and mucosa-associated lymphoid tissue lymphoma, and have a role in the development of other disorders, including gastric adenocarcinoma. FlexSure HP consists of a test strip, conjugate pad, and absorbent pad, in a novel reverse-flow chromatography format. In these studies, FlexSure HP was demonstrated to be specific for IgG antibodies against H. pylori. The reactive cutoff of the test was consistent with [13C]urea breath test and commercially available ELISAs. FlexSure HP had 94% sensitivity, 88% specificity, and 91% accuracy relative to [13C]urea breath test; and 95% sensitivity, 94% specificity, and 95% overall agreement relative to high-molecular-mass cell-associated protein enzyme immunoassay (HM-CAP EIA). FlexSure HP is a simple-to-perform, visually read test requiring no specialized training, equipment, or instrumentation, and yields rapid, accurate, qualitative results.

scholarly journals Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Tsachi Tsadok Perets ◽  
Hemda Schmilovitz-Weiss ◽  
Rachel Gingold-Belfer ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Treatment Success ◽  
Population Based ◽  
Urea Breath Test ◽  
First Line Therapy ◽  
13C Urea Breath Test ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

Positive serology indicates an active H. pylori infection in patients with atrophic gastritis in spite of negative histology and 13C-urea breath test

1998 ◽  
Vol 114 ◽  
pp. A183 ◽  
Author(s):  
A. Kokkola ◽  
P. Puolakkainen ◽  
H. Rautelin ◽  
P. Sipponen ◽  
M. Färkkilä ◽  
...  
Keyword(s):  
Atrophic Gastritis ◽  
Breath Test ◽  
Urea Breath Test ◽  
Positive Serology ◽  
13C Urea Breath Test ◽  
H Pylori

Knowledge of a negative 13C-urea breath test reduces health care utilisation for dyspepsia in a population H pylori test and treat program

2000 ◽  
Vol 118 (4) ◽  
pp. A678
Author(s):  
Paul Moayyedi ◽  
Richard Feltbower ◽  
Sara Duffett ◽  
Will Crocombe ◽  
David Forman ◽  
...  
Keyword(s):  
Health Care ◽  
Breath Test ◽  
Health Care Utilisation ◽  
Urea Breath Test ◽  
Test And Treat ◽  
Care Utilisation ◽  
13C Urea Breath Test ◽  
H Pylori

scholarly journals A Randomized Trial Comparing Seven-Day Ranitidine Bismuth Citrate and Clarithromycin Dual Therapy to Seven-Day Omeprazole, Clarithromycin and Amoxicillin Triple Therapy for the Eradication ofHelicobacter pylori

2003 ◽  
Vol 17 (9) ◽  
pp. 533-538 ◽  
Author(s):  
Sander Veldhuyzen van Zanten ◽  
Naoki Chiba ◽  
Alan Barkun ◽  
Carlo Fallone ◽  
Alain Farley ◽  
...  
Keyword(s):  
Dual Therapy ◽  
Success Rates ◽  
Open Label ◽  
Treatment Allocation ◽  
Ulcer Disease ◽  
Intention To Treat ◽  
Bismuth Citrate ◽  
The Difference ◽  
H Pylori

OBJECTIVE: To assessHelicobacter pylorieradication after one week dual ranitidine bismuth citrate-clarithromycin (RBC-C) or triple omeprazole, clarithromycin and amoxicillin (OCA) therapy.METHODS: In this multicentre Canadian trial,H pylori-positive patients with functional dyspepsia or inactive peptic ulcer disease were randomized to open-label treatment with RBC-C (ranitidine bismuth citrate 400 mg plus clarithromycin 500 mg) or OCA (omezaprole 20 mg, clarithromycin 500 mg and amoxicillin 1000 mg), given twice a day for seven days. Treatment allocation was randomly assigned.H pyloriinfection was confirmed by positive13C-urea breath test (13C-UBT).H pyloristatus was reassessed by UBT at least four and 12 weeks after treatment (negative: δ13CO2below 3.5 per mil). Intention-to-treat (ITT) eradication rates were determined for all patients with confirmedH pyloriinfection. Per protocol (PP) rate was determined for all patients treated with at least two evaluable follow-up visits.RESULTS: Three hundred five patients were included in the ITT and 222 in the PP analysis. The ITT eradication rates were 66% for RBC-C and 78% for OCA. The PP success rates were 84% for RBC-C and 96% for OCA. The difference for both ITT 12% (95% CI 2 to 22) and PP 12% (95% CI 4 to 19) were statistically significant, P=0.030 and P=0.007, respectively. Treatment was generally well tolerated.CONCLUSION: The eradication rate for the seven-day dual RBC-C regimen was lower than that for OCA.

scholarly journals Serology Is More Sensitive Than Urea Breath Test or Stool Antigen for the Initial Diagnosis of Helicobacter pylori Gastritis When Compared With Histopathology

2020 ◽  
Vol 154 (2) ◽  
pp. 255-265
Author(s):  
Dustin E Bosch ◽  
Niklas Krumm ◽  
Mark H Wener ◽  
Matthew M Yeh ◽  
Camtu D Truong ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Access To Care ◽  
Breath Test ◽  
Diagnostic Error ◽  
Urea Breath Test ◽  
Positive Serology ◽  
Noninvasive Test ◽  
Stool Antigen ◽  
And Performance ◽  
H Pylori

Abstract Objectives To assess the concordance and performance characteristics of Helicobacter pylori laboratory tests compared with histopathology and to propose algorithms for the diagnosis of H pylori that minimize diagnostic error. Methods H pylori diagnostics were reviewed from a 12-year period within a health system (2,560 cases). Analyses were performed to adjust diagnostic performance based on treatment and consensus histopathologic diagnoses among pathologists. Markers of access to care, including test cancellation frequency and turnaround time, were assessed. Costs and performance of candidate noninvasive testing algorithms were modeled as a function of disease prevalence. Results Serum H pylori IgG demonstrated a higher sensitivity (0.94) than urea breath and stool antigen tests (0.64 and 0.61, respectively). Evidence of an advantage in access to care for serology included a lower cancellation rate. Interobserver variability was higher (κ = 0.34) among pathologists for cases with a discordant laboratory test than concordant cases (κ = 0.56). A model testing algorithm utilizing serology for first-time diagnoses minimizes diagnostic error. Conclusions Although H pylori serology has modestly lower specificity than other noninvasive tests, the superior sensitivity and negative predictive value in our population support its use as a noninvasive test to rule out H pylori infection. Reflexive testing with positive serology followed by either stool antigen or urea breath test may optimize diagnostic accuracy in low-prevalence populations.

Sign in / Sign up

Export Citation Format

Share Document