Endoscopic diagnosis of Helicobacter pylori infection by rapid urease test in bleeding peptic ulcers

A prospective case-control study

Jui-Hsiang Tang, Nai Jen Liu, Hao Tsai Cheng, Ching Song Lee, Yin Yi Chu, Kai Feng Sung, Cheng Hui Lin, Yung Kuan Tsou, Jau Min Lien, Chi Liang Cheng

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

GOAL: To assess the efficacy of rapid urease test (RUT) in patients with bleeding ulcers, as well as the effects of visible blood in the stomach and short-term (<24 h) use of standard-dose proton pump inhibitor (PPI) on RUT sensitivity. BACKGROUND: The sensitivity of RUT in the diagnosis of Helicobacter pylori in upper gastrointestinal bleeding has been reported with conflicting results. STUDY: This was a prospective case-control study evaluating 324 consecutive patients with bleeding peptic ulcers (study group) and 164 with uncomplicated ulcers (control group). The presence of H. pylori infection was determined by both RUT and histology. Prevalence of H. pylori infection and the RUT sensitivity in diagnosing the bacteria between study and control groups were conducted. RESULTS: The prevalence of H. pylori infection in those with bleeding ulcers was significantly lower than that of controls (53.7% vs. 65.2%, P=0.015). The false-negative rate of RUT in the study group was significantly greater than that of the control group (16.7% vs. 5.6%, P=0.006), whereas the sensitivity rates in the study group with or without gastric blood were significantly lower than those of the controls (79.6% vs. 94.4%, P=0.005; 84.8% vs. 94.4%, P=0.019). There was no significant difference in RUT sensitivity between study group with or without visible gastric blood (P=0.41). The RUT sensitivity rate was also not significantly different between those treated with PPI and those without in patients with bleeding ulcers (82.7% vs. 85.7%, P=0.67). CONCLUSIONS: This study shows that the sensitivity of RUT in patients with bleeding ulcers is reduced. The presence of blood in the stomach and the short-term use of standard-dose PPI do not affect the RUT sensitivity in bleeding ulcers.

Original languageEnglish
Pages (from-to)133-139
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume43
Issue number2
DOIs
Publication statusPublished - Feb 1 2009
Externally publishedYes

Fingerprint

Urease
Helicobacter Infections
Peptic Ulcer
Helicobacter pylori
Case-Control Studies
Hemorrhage
Ulcer
Proton Pump Inhibitors
Stomach
Control Groups
Histology
Bacteria

Keywords

  • Bleeding ulcers
  • Helicobacter pylori
  • Rapid urease test

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Endoscopic diagnosis of Helicobacter pylori infection by rapid urease test in bleeding peptic ulcers : A prospective case-control study. / Tang, Jui-Hsiang; Liu, Nai Jen; Cheng, Hao Tsai; Lee, Ching Song; Chu, Yin Yi; Sung, Kai Feng; Lin, Cheng Hui; Tsou, Yung Kuan; Lien, Jau Min; Cheng, Chi Liang.

In: Journal of Clinical Gastroenterology, Vol. 43, No. 2, 01.02.2009, p. 133-139.

Research output: Contribution to journalArticle

Tang, Jui-Hsiang ; Liu, Nai Jen ; Cheng, Hao Tsai ; Lee, Ching Song ; Chu, Yin Yi ; Sung, Kai Feng ; Lin, Cheng Hui ; Tsou, Yung Kuan ; Lien, Jau Min ; Cheng, Chi Liang. / Endoscopic diagnosis of Helicobacter pylori infection by rapid urease test in bleeding peptic ulcers : A prospective case-control study. In: Journal of Clinical Gastroenterology. 2009 ; Vol. 43, No. 2. pp. 133-139.
@article{e245d694ab354e8bb1bcbb43fb40192c,
title = "Endoscopic diagnosis of Helicobacter pylori infection by rapid urease test in bleeding peptic ulcers: A prospective case-control study",
abstract = "GOAL: To assess the efficacy of rapid urease test (RUT) in patients with bleeding ulcers, as well as the effects of visible blood in the stomach and short-term (<24 h) use of standard-dose proton pump inhibitor (PPI) on RUT sensitivity. BACKGROUND: The sensitivity of RUT in the diagnosis of Helicobacter pylori in upper gastrointestinal bleeding has been reported with conflicting results. STUDY: This was a prospective case-control study evaluating 324 consecutive patients with bleeding peptic ulcers (study group) and 164 with uncomplicated ulcers (control group). The presence of H. pylori infection was determined by both RUT and histology. Prevalence of H. pylori infection and the RUT sensitivity in diagnosing the bacteria between study and control groups were conducted. RESULTS: The prevalence of H. pylori infection in those with bleeding ulcers was significantly lower than that of controls (53.7{\%} vs. 65.2{\%}, P=0.015). The false-negative rate of RUT in the study group was significantly greater than that of the control group (16.7{\%} vs. 5.6{\%}, P=0.006), whereas the sensitivity rates in the study group with or without gastric blood were significantly lower than those of the controls (79.6{\%} vs. 94.4{\%}, P=0.005; 84.8{\%} vs. 94.4{\%}, P=0.019). There was no significant difference in RUT sensitivity between study group with or without visible gastric blood (P=0.41). The RUT sensitivity rate was also not significantly different between those treated with PPI and those without in patients with bleeding ulcers (82.7{\%} vs. 85.7{\%}, P=0.67). CONCLUSIONS: This study shows that the sensitivity of RUT in patients with bleeding ulcers is reduced. The presence of blood in the stomach and the short-term use of standard-dose PPI do not affect the RUT sensitivity in bleeding ulcers.",
keywords = "Bleeding ulcers, Helicobacter pylori, Rapid urease test",
author = "Jui-Hsiang Tang and Liu, {Nai Jen} and Cheng, {Hao Tsai} and Lee, {Ching Song} and Chu, {Yin Yi} and Sung, {Kai Feng} and Lin, {Cheng Hui} and Tsou, {Yung Kuan} and Lien, {Jau Min} and Cheng, {Chi Liang}",
year = "2009",
month = "2",
day = "1",
doi = "10.1097/MCG.0b013e31816466ec",
language = "English",
volume = "43",
pages = "133--139",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Endoscopic diagnosis of Helicobacter pylori infection by rapid urease test in bleeding peptic ulcers

T2 - A prospective case-control study

AU - Tang, Jui-Hsiang

AU - Liu, Nai Jen

AU - Cheng, Hao Tsai

AU - Lee, Ching Song

AU - Chu, Yin Yi

AU - Sung, Kai Feng

AU - Lin, Cheng Hui

AU - Tsou, Yung Kuan

AU - Lien, Jau Min

AU - Cheng, Chi Liang

PY - 2009/2/1

Y1 - 2009/2/1

N2 - GOAL: To assess the efficacy of rapid urease test (RUT) in patients with bleeding ulcers, as well as the effects of visible blood in the stomach and short-term (<24 h) use of standard-dose proton pump inhibitor (PPI) on RUT sensitivity. BACKGROUND: The sensitivity of RUT in the diagnosis of Helicobacter pylori in upper gastrointestinal bleeding has been reported with conflicting results. STUDY: This was a prospective case-control study evaluating 324 consecutive patients with bleeding peptic ulcers (study group) and 164 with uncomplicated ulcers (control group). The presence of H. pylori infection was determined by both RUT and histology. Prevalence of H. pylori infection and the RUT sensitivity in diagnosing the bacteria between study and control groups were conducted. RESULTS: The prevalence of H. pylori infection in those with bleeding ulcers was significantly lower than that of controls (53.7% vs. 65.2%, P=0.015). The false-negative rate of RUT in the study group was significantly greater than that of the control group (16.7% vs. 5.6%, P=0.006), whereas the sensitivity rates in the study group with or without gastric blood were significantly lower than those of the controls (79.6% vs. 94.4%, P=0.005; 84.8% vs. 94.4%, P=0.019). There was no significant difference in RUT sensitivity between study group with or without visible gastric blood (P=0.41). The RUT sensitivity rate was also not significantly different between those treated with PPI and those without in patients with bleeding ulcers (82.7% vs. 85.7%, P=0.67). CONCLUSIONS: This study shows that the sensitivity of RUT in patients with bleeding ulcers is reduced. The presence of blood in the stomach and the short-term use of standard-dose PPI do not affect the RUT sensitivity in bleeding ulcers.

AB - GOAL: To assess the efficacy of rapid urease test (RUT) in patients with bleeding ulcers, as well as the effects of visible blood in the stomach and short-term (<24 h) use of standard-dose proton pump inhibitor (PPI) on RUT sensitivity. BACKGROUND: The sensitivity of RUT in the diagnosis of Helicobacter pylori in upper gastrointestinal bleeding has been reported with conflicting results. STUDY: This was a prospective case-control study evaluating 324 consecutive patients with bleeding peptic ulcers (study group) and 164 with uncomplicated ulcers (control group). The presence of H. pylori infection was determined by both RUT and histology. Prevalence of H. pylori infection and the RUT sensitivity in diagnosing the bacteria between study and control groups were conducted. RESULTS: The prevalence of H. pylori infection in those with bleeding ulcers was significantly lower than that of controls (53.7% vs. 65.2%, P=0.015). The false-negative rate of RUT in the study group was significantly greater than that of the control group (16.7% vs. 5.6%, P=0.006), whereas the sensitivity rates in the study group with or without gastric blood were significantly lower than those of the controls (79.6% vs. 94.4%, P=0.005; 84.8% vs. 94.4%, P=0.019). There was no significant difference in RUT sensitivity between study group with or without visible gastric blood (P=0.41). The RUT sensitivity rate was also not significantly different between those treated with PPI and those without in patients with bleeding ulcers (82.7% vs. 85.7%, P=0.67). CONCLUSIONS: This study shows that the sensitivity of RUT in patients with bleeding ulcers is reduced. The presence of blood in the stomach and the short-term use of standard-dose PPI do not affect the RUT sensitivity in bleeding ulcers.

KW - Bleeding ulcers

KW - Helicobacter pylori

KW - Rapid urease test

UR - http://www.scopus.com/inward/record.url?scp=64749095414&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=64749095414&partnerID=8YFLogxK

U2 - 10.1097/MCG.0b013e31816466ec

DO - 10.1097/MCG.0b013e31816466ec

M3 - Article

VL - 43

SP - 133

EP - 139

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 2

ER -