Urea Breath Tests for Detection of Helicobacter pylori
نویسندگان
چکیده
The association ofHelicobacter pyloriwith peptic ulcer disease and gastric cancer was first proposed by Warren and Marshall in 1983 (Warren and Marshall, 1983). In February 1994, the National Institutes of Health Consensus Development Conference concluded thatH. pylori infection is themajor cause of peptic ulcer disease, and all patients with confirmed peptic ulcer disease associatedwithH. pylori infection should receive treatment with antimicrobial agents (Yamada et al., 1994). The International Agency for Research on Cancer Working Group of the World Health Organization categorized H. pylori as a group I, or definite, human carcinogen (Versalovic, 2003). Based on the data retrieved during the National Health Interview Survey of 1989, 10% of adult U.S. residents reported physician-diagnosed ulcer disease, among whom one third had an ulcer in the past year (Sonnenberg and Everhart, 1996). In developing countries, the prevalence of H. pylori carriers can be as high as 70–90%. Most patients acquire the infection at childhood. The prevalence of the infection in developed countries is lower, ranging from 25% to 50% (Dunn et al., 1997). Seroprevalence studies demonstrate an increasing rate in adults of 3–4% per decade (Cullen et al., 1993; Sipponen et al., 1996; Kosunen et al., 1997; Versalovic, 2003). H. pylori–infected patients may develop chronic gastric inflammation that can be asymptomatic. Infection of H. pylori is associated with peptic ulcer disease (Dunn et al., 1997). H. pylori infection is also associated with gastric adenocarcinoma (Oconnor et al., 1996) and mucosa-associated lymphoid tissue (MALT) lymphoma (Isaacson, 1994). The AmericanMedical Association published guidelines for testing and treatment of H. pylori–related disease (Peterson et al., 2000). The panel of experts recommends testing forH. pylori in patientswith active ulcers, a history of ulcers, or gastric mucosa–associated lymphoid tissue lymphomas, and young patients with ulcer-like dyspepsia and those with family history should also be tested forH. pylori. Eradication of the infection leads to cure of the ulcers (Dunn et al., 1997). Treatment of the infection with antibiotics includes twice-daily triple
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