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δ13CO2 Excretion and Expression of Dyspeptic Symptoms in Patients Evaluated for Helicobacter pylori Infection by [13C] Urea Breath Test

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Abstract

Previous studies showed that either the urease activity possessed by H. pylori and the bacterial load may influence the results of the [13C] urea breath test. However, the correlation between urease activity and dyspepsia is unclear. The aim of our study was to evaluate whether the urease activity of the gastroduodenal tract may influence the severity of dyspeptic symptoms. In all, 2520 dyspeptic patients (1109 men, 1411 women; mean age 47 ± 16 years) without gastroesophageal reflux disease, diabetes, vascular disorders, liver and biliary tract diseases, and tumors of the gastrointestinal tract and with a normal appearing abdominal ultrasonography were enrolled. All these patients underwent a [13C] urea breath test and filled out a questionnaire on dyspeptic symptoms. Subjects were divided in five different groups according to delta over baseline (DOB) values (group 1 < 3.5, group 2 = 3.5–6; group 3 = 6.1–11, group 4 = 11.1–23, group 5 > 23.1). The prevalence and intensity of dyspeptic symptoms were compared among groups. In all, 1688 patients (67%, 928 females and 760 males; mean age 48 ± 15 years) were H. pylori-positive. The chi-squared test and analysis of variance showed increase of frequency and intensity of each dyspeptic symptom according to DOB values. In conclusion, Dyspepsia may parallel gastric urease activity. However, whether higher DOB values are related to higher bacterial load or, alternatively, to the presence of particular H. pylori strains able to produce larger amounts of urease is uncertain.

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REFERENCES

  1. Covacci A, Telford JL, del Giudice G, Parsonnet J, Rappuoli R: Helicobacter pylori virulence and genetic geography. Science 284:1328–1333, 1999

    PubMed  Google Scholar 

  2. McCarthy C, Patchett S, Collins RM, Beattie S, Keane C, O'Morain C: Long-term prospective study of Helicobacter pylori in nonulcer dyspepsia. Dig Dis Sci 40:114–119, 1995

    PubMed  Google Scholar 

  3. O'Morain C, Gilvarry G: Eradication of Helicobacter pylori in patients with non-ulcer dyspepsia. Scand J Gastroenterol 28:30–33, 1993

    Google Scholar 

  4. Bernersen B, Johnsen R, Bostad L, Straume B, Sommer AI, Burhol PG. Is Helicobacter pylori the cause of dyspepsia? BMJ 304:1276–1279, 1992

    PubMed  Google Scholar 

  5. Jaakkimainen RL, Boyle E, Tudiver F: Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ 319:1040–1044, 1999

    PubMed  Google Scholar 

  6. Langenberg W, Tytgat GNJ, Schipper MEI, Rietra PJGM, Zanen HC: Campylobacter-like organisms in the stomachs of patients and healthy individuals. Lancet 1:1348, 1984

    PubMed  Google Scholar 

  7. Graham DY, Klein PD, Evans DJ, Evans DG, Alpert LC, Opekun AR, Boutton TW: Campylobacter pylori detected noninvasively by the 13C-urea breath test. Lancet 1:1174–1177, 1987

    PubMed  Google Scholar 

  8. Figura N. Are Helicobacter pylori differences important in the development of Helicobacter pylori-related diseases? Ital J Gastroenterol Hepatol 29:367–374, 1997

    PubMed  Google Scholar 

  9. Bazzoli F, Zagari RM, Pozzato P, Fossi S, Alampi G, Sottili S: 13C-urea breath test to quantify H. pylori colonization of gastric mucosa and association with severity of inflammation. Gastroenterology 106:A48, 1994

    Google Scholar 

  10. Perri F, Clemente R, Pastore M, Quitadamo M, Festa V, Bisceglia M, Li Bergoli M, Lauriola G, Leandro G, Ghoos Y, Rutgeerts P, Andriulli A: The 13C-urea breath test as a predictor of intragastric bacterial load and severity of Helicobacter pylori gastritis. Scand J Clin Lab Invest 58:19–28, 1998

    PubMed  Google Scholar 

  11. Bukley MJ, Scanlon C, McGurgan P, O'Morain C: A validated dyspepsia symptom score. Ital J Gastroenterol Hepatol 29:495–500, 1997

    PubMed  Google Scholar 

  12. Talley NJ, Vakil N, Ballard ED 2nd, Fennerty MB: Absence of benefit of eradicating Helicobacter pylori in patients with nonulcer dyspepsia. N Engl J Med 341:1106–1111, 1999

    PubMed  Google Scholar 

  13. Werdmuller BF, Van der Putten AB, Veenendaal RA, Lamers B, Balk AG, Loffeld RJ: Functional dyspepsia has a good prognosis irrespective of H. pylori status. Long-term follow-up of symptoms after anti H. pylori treatment. Neth J Med 55:64–70, 1999

    PubMed  Google Scholar 

  14. Blum AL, Talley NJ, O'Morain C, van Zanten SV, Labenz J, Stolte M, Louw JA, Stubberod A, Theodors A, Sundin M, Bolling-Sternewald E, Junghard O: Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. Omeprazole plus clarithromycin and amoxicillin effect one year after treatment (OCAY) Study Group. N Engl J Med 339:1875–1881, 1998

    PubMed  Google Scholar 

  15. Elta GH, Scheiman JM, Barnett JL, Nostrant TT, Behler EM, Crause I, Appelman HD: Long-term follow-up of Helicobacter pylori treatment in non-ulcer dyspepsia patients. Am J Gastroenterol 90:1089–1093, 1995

    PubMed  Google Scholar 

  16. Braden B, Wolfgang F, Caspary F, Lembcke B: Density of gastric Helicobacter pylori colonization is not associated with occurrence of dyspeptic symptoms. Dig Dis Sci 42:2120–2123, 1997

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Internal Medicine Department, Catholic, University of Rome, Rome, Italy

    Francesco Franceschi, Alessandro Armuzzi, Filippo Cremonini, Emilia Carloni, Maria Assunta Zocco, Simona Di Caro, Cristiano Padalino, Paolo Pola, Giovanni Gasbarrini & Antonio Gasbarrini

  2. Baylor College of Medicine, VA Medical Center, Houston, Texas, USA

    Francesco Franceschi & Robert M. Genta

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  1. Francesco Franceschi
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  2. Alessandro Armuzzi
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  3. Filippo Cremonini
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  4. Emilia Carloni
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  5. Maria Assunta Zocco
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  6. Simona Di Caro
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  7. Cristiano Padalino
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  11. Antonio Gasbarrini
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Franceschi, F., Armuzzi, A., Cremonini, F. et al. δ13CO2 Excretion and Expression of Dyspeptic Symptoms in Patients Evaluated for Helicobacter pylori Infection by [13C] Urea Breath Test. Dig Dis Sci 47, 804–808 (2002). https://doi.org/10.1023/A:1014700319068

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