Urea breath tests for detection of helicobacter pylori

The association of Helicobacter pylori with peptic ulcer disease and gastric cancer was first proposed by Warren and Marshall in 1983 (Warren and Marshall, 1983). In February 1994, the National Institutes of Health Consensus Development Conference concluded that H. pylori infection is the major cause of peptic ulcer disease, and all patients with confirmed peptic ulcer disease associated with H. pylori infection should receive treatment with antimicrobial agents (Yamada et al., 1994). The International Agency for Research on CancerWorking Group of theWorld Health Organization categorized H. pylori as a group I, or definite, human carcinogen (Versalovic, 2003). Based on the data retrieved during the National Health Interview Survey of 1989, 10% of adult U.S. residents reported physician-diagnosed ulcer disease, among whom one third had an ulcer in the past year (Sonnenberg and Everhart, 1996). In developing countries, the prevalence of H. pylori carriers can be as high as 70-90%. Most patients acquire the infection at childhood. The prevalence of the infection in developed countries is lower, ranging from 25% to 50% (Dunn et al., 1997). Seroprevalence studies demonstrate an increasing rate in adults of 3-4% per decade (Cullen et al., 1993; Sipponen et al., 1996; Kosunen et al., 1997; Versalovic, 2003).