Is Urea Breath Test a Gold Standard for Diagnosis of H. pylori Infection?

The urea breath test UBT C13,14 is a good rapid diagnostic procedure used to identify stomach infections by H. pylori. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide. Urea breath tests are recommended in leading society guidelines as a preferred non-invasive choice for detecting H. pylori of stomach before and after treatment with diagnostic efficacy at 96.7% sensitivity and 96.2% specificity. However UBT is not a test for detection H. pylori in the mouth. We found that UBT C13 can’t detecting H. pylori in oral cavity such as a person has dysfunction of color blind that can’t see well for certain color. In medical practice, patients with negative results in UBT C13 suggest that their stomach infection of H. pylori is cured. In fact, patients can present negative UBT results and yet exhibit H. pylori infection due to oral infection. The clinical study provides evidence that H. pylori oral infection is nonetheless present. In Asia, more than 20-30 % of the population suffered from oral H. pylori infection but had negative UBT results [1]. This study also showed that oral antigen screening test (HPS) could identify individuals who have no risk for H. pylori gastric but oral infection. It further identified persons with no symptoms but with antigenic evidence of possible oral H. pylori infection who are thus at risk for developing gastric disease. This information was not provided by UBT methods.