Confirming H pylori eradication is difficult. Most tests require endoscopy, which is invasive, uncomfortable, time- consuming, and expensive. Urea breath tests are noninvasive and easy to perform, but the 13C test is expensive and the 14C test requires radioisotope handling, and neither are available yet in the US. Given the choices, most patients decline follow-up (unless there is a complication such as bleeding). Recently, Phull et al reported that there may be an easy way to confirm cure: ask the patient.
Phull et al studied 112 duodenal ulcer patients before and after treatment with antibiotics plus omeprazole or lansoprazole and/or colloidal bismuth subcitrate. At one and six months after completion of treatment, urea breath tests were administered and data collected on dyspeptic symptoms (epigastric discomfort, heartburn, nausea, vomiting, and gas). Absence of symptoms was considered indicative of successful eradication. At 6 months, there was a high correlation between dyspeptic symptoms and breath test results. Absence of symptoms was an excellent indicator of successful H pylori eradication; sensitivity was 97.5% and specificity 90.6%.
Phull PS et al. Brit Med J.
Phull et al studied 112 duodenal ulcer patients before and after treatment with antibiotics plus omeprazole or lansoprazole and/or colloidal bismuth subcitrate. At one and six months after completion of treatment, urea breath tests were administered and data collected on dyspeptic symptoms (epigastric discomfort, heartburn, nausea, vomiting, and gas). Absence of symptoms was considered indicative of successful eradication. At 6 months, there was a high correlation between dyspeptic symptoms and breath test results. Absence of symptoms was an excellent indicator of successful H pylori eradication; sensitivity was 97.5% and specificity 90.6%.
Phull PS et al. Brit Med J.
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