UBT as a Diagnostic Tool for HP Prevalance
UBT as a Diagnostic Tool for HP Prevalance
The prevalence of H. pylori infection in Pakistan is unknown and investigators want to assess
 it in dyspeptic patients utilizing UBT. At the same time investigators want to validate UBT
 sensitivity and specificity in Pakistani patients
The non-invasive methods for the diagnosis of Hp are the Urea Breath Test (UBT) and
 serological tests. The serological tests includes ELISA test in serum for Hp antibody and in
 stool for Hp antigen. Serum ELISA Hp antibody is not sensitive for showing active infection
 and the titres do not decrease even after successful eradication. Serology test cannot be
 used for those who have previously been treated for Hp, as the decline in titre of Hp
 antibodies is too slow to be of practical use. The stool Hp antigen detection test is more
 sensitive and specific as it detects bacterial antigens which will only be positive in the
 presence of Hp. However, it is cumbersome to collect stool and laboratory services are
 required. The C14 Urea Breath Test (UBT) is an office based test with sensitivity and
 specificity comparable to that of the stool antigen test. The diagnostic validity of these
 tests depends on the prevalence of H pylori infection. A higher prevalence would be
 associated with higher sensitivity and lower specificity. The safety profile of the urea
 breath test is very favourable, and no major side effects are associated with it. The aims of
 this study are to estimate H pylori prevalence in Pakistan among the adult dyspeptic
 population and to validate the sensitivity and specificity UBT in our population
Inclusion Criteria:

 -  Male and female subjects with dyspeptic symptoms (B1 Criteria of FD)

 -  Subject who has not been treated for H pylori eradication in the past

 -  Age above 18 years

 -  No Alarm symptoms of :

 -  Gastrointestinal Bleeding

 -  Anemia

 -  Early satiety

 -  Unexplained weight loss

 -  Progressive dysphagia

 -  Odynophagia

 -  Recurrent vomiting

 -  Family history of GI malignancy

 -  Previous GI malignancy

 Exclusion Criteria:

 -  Pregnant females

 -  Use of NSAIDs

 -  Use of anti- secretory agent (H2 blockers) and proton pump inhibitors in previous 4
 weeks

 -  Use of anti- microbial agents (Clarithromycin, Metronidazole, Amoxacillin, quinalones)
 or bismuth in last 4 weeks

 -  .Gastric and/or duodenal erosions or ulcers, polyps or malignancy if noted on
 endoscopy will be excluded.

 -  Patients with predominant symptoms or gastro esophageal reflux disease (GERD) or
 Endoscopic evidence of esophagitis.

 -  Patients with abnormal upper abdominal ultrasound.