Rapid 13(c) urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain

Authors

Andrew C. Meltzer, George Washington UniversityFollow
Rebecca Pierce, Johns Hopkins University
Derek A.T. Cummings, Johns Hopkins University
Jesse M. Pines, George Washington UniversityFollow
Larissa May, George Washington UniversityFollow
Meaghan A. Smith, George Washington UniversityFollow
Joseph Marcotte, George Washington University
Melissa L. McCarthy, George Washington UniversityFollow

Document Type

Journal Article

Publication Date

5-2013

Journal

Western Journal of Emergency Medicine

Volume

Volume 14, Issue 3

Inclusive Pages

278-282

Abstract

Introduction: In emergency department (ED) patients with upper abdominal pain, management includes ruling out serious diseases and providing symptomatic relief. One of the major causes of upper abdominal pain is an ulcer caused by Helicobacter pylori (H. pylori), which can be treated and cured with antibiotics. We sought to estimate the prevalence of H. pylori infection in symptomatic patients using a convenience sample at a single urban academic ED and demonstrate the feasibility of ED-based testing.

Methods: We prospectively enrolled patients with a chief complaint of pain or discomfort in the upper abdomen for 1 year from February 2011 until February 2012 at a single academic urban ED. Enrolled subjects were tested for H. pylori using a rapid point of care 13C Urea Breath Test (UBT) [Exalenz Bioscience]. We compared patient characteristics between those who tested positive versus negative for the disease.

Results: A total of 205 patients with upper abdominal pain were tested over 12 months, and 24% (95% confidence interval: 19% to 30%) tested positive for H. pylori. Black subjects were more likely to test positive than white subjects (28% v. 6%, P < 0.001). Other factors, such as age and sex, were not different between the 2 groups.

Conclusion: In our ED, H. pylori infection was present in 1 in 4 patients with epigastric pain, and testing with a UBT was feasible. Further study is needed to determine the risk factors associated with infection, the prevalence of H. pylori in other EDs, the effect of the test on ED length of stay and the cost-effectiveness of an ED-based test-and-treat strategy. [West J Emerg Med. 2013;14(3):278–282.]

Comments

Reproduced with permission of Western Journal of Emergency Medicine.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License

APA Citation

Meltzer, A.C., Pierce, R., Cummings, D.A., Pines, J.M., May, L., Smith, M.A., Marcotte, J., McCarthy, M.L. (2013). Rapid 13(c) urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. Western Journal of Emergency Medicine, 14(3), 278-282.

Peer Reviewed

1

Open Access

1