Screening of Helicobacter Pylori Infection in the Health Examination Detected by Urea Breath Test and Barium Meal study

Fumihiro YAMASAWA, et al

Marubeni Clinic

Helicobacter priori, Urea breath test, Barium meal study, stable isotope, Mass spectrometer, Anti Helicobacter pylori IgG. Gastric cancer, Health examination F. Yamasawa, Marubeni Clinic, 4-2 Ohtemachi 1, Chiyoda-ku, Tokyo100-88, Japan J Occup Healthyear1998Vol40No132-36

Background: Helicobacter pylori, H. pylori, is now assumed to be a definite cause of gastric cancer. Health examinations for the early detection of atherosclerotic diseases and malignant diseases have been widely undertaken in Japan, where the incidence of gastric cancer is still one of the highest in the world. To investigate H. pylori infection non-invasively in the regular health examinations, we introduced the urea breath test (UBT) with a barium meal study in the ordinary system. Methods: sixty male subjects were studied (mean age: 47.8 y/o) in this study. After blood examination for anti H. pylori IgG antibody, the reference expired gas was collected from each subject. Then the subject took 100mg of 13C-urea dissolved in water with tartaric acid and sodium bicarbonate, which has used to distend the stomach, and an ordinary barium meal study was undertaken several rotations of the body were added to subjects for fluoroscopy. Thirty minutes after 13C-urea intake, the expired gas was collected again as the second gas sample. The ratio of 13C to 12C in the reference and second expired gas sample was measured with a mass spectrometer and the changed fraction of the isotope concentration, d, was calculated in each subject. The X-ray films of the barium meal study were read independently by one roentgenologist who was not informed at all about this study. Cases were divided into 2 groups: one group without mucosal inflammatory diseases and another group with mucosal inflammatory diseases. Results: The d value for subjects with positive H. pylori antibody and with mucosal inflammatory diseases, who were strongly suggestive of positive H. pylori infection, had a significantly higher value (d: 2.492 plusmn 1.372, p<0.001) than that for subjects with negative H. pylori antibody and without mucosal inflammatory disease who were thought not to have H. pylori infection (0.141 plusmn 0.107). Subjects who were strongly suggestive of H. pylori infection showed distinctly high value. Conclusions: Barium did not interfere with the reaction of H. pylori and 13C-urea in the gastric mucosa. UBT can be performed non-invasively together with a barium meal study and it provides useful information on H. pylori infection in the health examination.