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

Andrew C. Meltzer, Rebecca Pierce, Derek A T Cummings, Jesse M. Pines, Larissa S May, Meaghan A. Smith, Joseph Marcotte, Melissa L. McCarthy

Research output: Contribution to journalArticle

3 Citations (Scopus)

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 costeffectiveness of an ED-based test-and-treat strategy.

Original languageEnglish (US)
Pages (from-to)278-282
Number of pages5
JournalWestern Journal of Emergency Medicine
Volume14
Issue number3
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Breath Tests
Helicobacter Infections
Helicobacter pylori
Abdominal Pain
Urea
Hospital Emergency Service
Point-of-Care Systems
Pain
Pain Management
Abdomen
Ulcer
Length of Stay
Confidence Intervals
Anti-Bacterial Agents
Infection

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Rapid 13C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. / Meltzer, Andrew C.; Pierce, Rebecca; Cummings, Derek A T; Pines, Jesse M.; May, Larissa S; Smith, Meaghan A.; Marcotte, Joseph; McCarthy, Melissa L.

In: Western Journal of Emergency Medicine, Vol. 14, No. 3, 2013, p. 278-282.

Research output: Contribution to journalArticle

Meltzer, Andrew C. ; Pierce, Rebecca ; Cummings, Derek A T ; Pines, Jesse M. ; May, Larissa S ; Smith, Meaghan A. ; Marcotte, Joseph ; McCarthy, Melissa L. / Rapid 13C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. In: Western Journal of Emergency Medicine. 2013 ; Vol. 14, No. 3. pp. 278-282.
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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 costeffectiveness of an ED-based test-and-treat strategy.",
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