Urea breath test and rapid urease test

Abstract

The urea breath test (UBT) and the rapid urease test (RUT) are the most commonly used diagnostic methods for H. pylori infection and rely on detecting the presence of urease produced by H. pylori. The sensitivity of the UBT is excellent (often exceeding 95 %). The majority of false-positive results after eradication occur when the results are near the cutoff value and are most frequent in areas where atrophic gastritis is common and citric acid is not used as an adjuvant. The sensitivity of RUT is slightly less (approximately 80–95 %). Increasing the number and size of biopsy fragments, collecting them from the antrum and corpus, or sampling gastric mucus more widely instead of biopsy samples achieves better results with the RUT. Negative results of the either test should not be taken as evidence of the absence of the infection especially in PPI users as well as in patients with bleeding or a history of partial gastrectomy.